Episode 2 Helicopter Heroes

'It's one of the most beautiful but dangerous places on earth.'

My name's Helen, I'm one of the doctors.

Any pain in there, any teeth loose, or anything like that?

'And when Australians call out the flying doctor, they are likely to be British

'and so is the pilot, paramedic and crewman.'

We'll see lots of sharks 200, 300 metres out.

I think they get the idea when we go like that.

They said they have got the bends from coming up.

'From shark attacks on surfing beaches, to exploding BBQs in the Sydney suburbs,

'these are the Brits who can make the difference between life and death Down Under.'

'James Milligan is an NHS consultant working at Leeds General Infirmary.'

How's that tummy pain, then?

'Now, like hundreds of medics every year, he's swapping rainy Britain for a life in the sun.'

We're living right by the ocean, it's a beautiful spot.

Work's nice and relaxed, the atmosphere is great.

Life probably couldn't be much better.

'But it's a place where the nearest hospital can be 200 miles away and the wildlife can kill you.'

You ready? Can I have a listen to your heart?

'Welcome to one of the world's most extreme health services.'

'Today, there's a gangland shooting in a Sydney Street and the rescue helicopter is in the firing line.'

-No guns still there?

-We'll find out in a minute.

'A barbeque blows up at a family campsite.'

He's a bit annoyed his barbeque hasn't happened, but that's life!

'And four mates go for a ride in the woods - now one of them needs emergency care.'

'In under two and a half centuries, Sydney has grown from a pioneer town of fewer than 1,000 settlers

'to a city of four and a half million.

'And in each year those numbers are swollen by two and half million visitors from overseas.

'But like any large city, Sydney has it's own problems with a criminal underworld.

'Drugs, gang violence and organised crime are major problems

'and the flying doctors like James Milligan often come face to face with them.'

Like any other large major city, it has its nice areas

and it has its areas that are slightly more troubled.

But there are definitely areas where organised crime is a real problem, particularly around drugs.

'Even though the Aussie murder rate is lower than Britain's, guns are used in more crimes down under

'and Australians are three times more likely to be shot dead than Brits.'

There have unfortunately been a few shooting incidents

and most of those incidents have been gang-related.

If the scene isn't safe and there is a risk that we could potentially get shot at ourselves,

we always speak to the police before entering any kind of high-risk area like that.

'And although it feels more dangerous at night,

'crews are just as likely to be called to gangland shootings in the day.'

We're just inside Richmond.

'The CareFlight helicopter is mainly funded by charity

'and is separate from the New South Wales Ambulance Service.

'Today, it's been scrambled to an incident in the suburbs.'

Good morning, go ahead.

One male patient, clear gunshot wound to the head.

Coming up to three miles and 279.

'Air Crew Officer John Legge, known as Leggy, is no stranger to gunshot wounds.

'He did six tours of Afghanistan with the RAF,

'rescuing wounded soldiers from the battlefield.

'But this is a different kind of war and the CareFlight team could be in the firing line.'

A gunshot wound.

No gun still there?

We'll find out in a minute.

'The suburb where CareFlight 4 is landing is the scene of a turf war between rival gangs.'

OK, there's the ambulance there, 3 o'clock, range about half a mile.

There is where we want to put down, this one.

-Right, do you want to put it to the south of that white truck?

-Yeah.

'This is the part of Sydney that doesn't feature in the tourist brochures.

'Flying doctor Alan Garner is an A&E consultant - if anyone can save this man's life, it's him.'

He has just a wound to the head as far as we can tell.

As far as we can see there. We haven't been able any sort of exit wound.

It's only a question of how long we keep going for.

'Gun crime is a growing problem in the Sydney suburbs

'and this incident's already being linked to another shooting earlier in the day.

'Feelings are running high.'

I heard two shots ringing out.

The first shot didn't sound like much,

but the second shot rang out and then I heard the screaming.

So I come down to see what's going on, but it doesn't look good.

More knives and that, you know? Very rarely.

No one gets shot around here, I haven't seen someone get shot for a long time.

We get some adrenaline in and we still haven't got nothing after 20 minutes.

His face is just a complete mess.

'While the medics work, crewman John's job is to look after CareFlight 4

'and he's concerned about the crowds.'

How are you doing? I was just about to call you guys. We will be able to get the car?

You won't be able to stay at the aircraft at all, because we're going to get quite a crowd here now.

'The police understandably are preoccupied with finding the gunman.'

They're pretty tied up at the minute, I reckon we give them five minutes or something

and if we see one... In fact, I'll just give them another call

and I'll just say we need another car, because we will need one.

I can't do anything about these.

'John faces a dilemma - without police help CareFlight 4

might not be able to take off to fly the patient to hospital.'

A helicopter when it's got its rotors turning and burning, is quite dangerous.

Not everybody understands that, so we need to make sure that there is good crowd control

so when we take off people don't run in the tail rotor.

And come under the disks where they can get hurt.

'The patient is critically ill, Dr Alan and the paramedics are struggling to keep the man alive.'

OK, then I think once we have got those accesses,

we tie this tube and we get out of here.

'At nearby Westmead Hospital, a trauma team's on standby.

'Dr Alan decides he'll have more room to work on his patient if they go by road.

'The rest of the CareFlight team will go by air.'

If these people move to these posts here.

'At last police officers have been assigned to protect the public as the helicopter takes off.'

OK, I've got clearance from Richmond to get airborne not above 1,000 for departure.

OK, just looking for the police helicopter.

'But soon after CareFlight 4 arrives back at base there's bad news about the team's patient.'

"A man is dead and another injured in separate shootings in Sydney's west."

"The victims were shot in broad daylight just streets from each other in full view of neighbours."

"The 31-year-old victim of Sydney's third fatal shooting this year

was shot outside a row of houses around one o'clock this afternoon."

"Mortally wounded, he lay down in the middle of the road."

There does seem to be a bit more of a gun culture in the bigger cities of Australia,

just from what I can gather.

I'm not an expert in it, but it does seem to be more frequent than back home.

'In Sydney, the majority of shootings involve criminals killing other criminals,

'but that makes no difference to the medical teams treating them.'

'It's summer in New South Wales and the temperature's pushing 40 Celsius,

'that's 100 degrees in old money.

'It's the kind of weather that has Aussies heading for the great outdoors.'

The weather is just so much better than back home and our level of call-outs has really rocketed,

because people are just outside doing all sorts of things.

Rock climbing, canyoning.

My colleagues have just gone off to look for somebody lost on a bush walk.

And motocross riders, for example, are out all of the time as well.

'That's what Matt Harris is doing today,

'with three mates, four dirt bikes and a head camera.'

Hello!

'It's a lot of fun... until this happens.'

Dude, you all right?

How you feeling?

I think he knocked himself out.

'Matt is badly injured.

'He desperately needs the expertise of Dr Hilary, who's from Manchester,

'and the rest of the crew of the New South Wales Ambulance Service Helicopter.'

So when we get there, both the packs we want to take with us.

'Matt is suffering fits - the sign of a serious head injury.'

I think he's coming to.

I think you leave the helmet on.

We were going about 50 Ks, I was behind him,

and all of a sudden he started going over the hangers

and the bike just dropped and he just kept rolling.

He wasn't responsive at all and it freaked us all out a lot.

We need an ambo, I think.

-He still breathing?

-Yeah. Leave him. He's a little roughed.

-His arm was like - it was a seizure or something.

-He was having a seizure at one point, man.

'The helicopter is just minutes away but the pilot's worried dust

'kicked up by the chopper's downdraft might make the landing tricky.'

On the grass there, it's going to be browned out once the rotor washes that dust.

-Yeah, it's going to stay mucky.

-And here comes the grass. Turn the flat line.

'Matt is lucky - Dr Hilary is an anaesthetist

'with years of experience at Manchester's Wythenshawe Hospital.

'Now that expertise is being put to good use here in the Australian bush.'

He was unconscious for probably five minutes.

We've been down here heaps of times before

and never really had this sort of accident before.

Just been sitting there with him and trying to keep the dust out of his eyes

and keeping him calm, trying not to move his head around too much, in case of a neck injury.

I seriously can't breathe. I'm not exaggerating, I can't breathe.

It was pretty nasty, yeah, I was pretty worried.

You stay nice and still, mate.

His conscious level's completely normal at the moment.

He's got a couple of cuts and bruises, but listening to his chest, he's absolutely fine.

His abdomen's fine.

So all we've done for him is, as a precautionary measure, we have put a cervical collar on,

because looking at his motorcycle helmet, he's got a really deep cut to the back of it.

It's cracked the inside and the outside.

You guys are top notch.

'Dr Hilary knows Matt could have a brain injury and the impact may also have damaged his spine.

'He needs scans and X-rays.'

And those helmets, they don't crack unless you take some sort of force on it, OK?

So we just want to make sure that later on you don't end up with

any swelling in your head, because you've hit your head so hard, OK?

Any chance of getting the window seat?

You got one, you just can't sit up and look out of it.

It will take us 10 or 15 minutes to get him to Westmead and if he was to go by road to another hospital

it would take an hour on quite bumpy and windy roads.

Sidney operations rescue 24, we have one patient for Westmead Hospital.

Taxi on hand for the patient now maintains a GCS of 15.

He's tachycardia with a rate of 115.

Complaining of sudden knee pain. Other than that, he's not symptomatic.

'Matt's been flown to one of Sydney's biggest hospitals, the Westmead.

'It's here that a scan reveals a bleed on the brain.

'For two days, Matt's kept under close observation and given drugs to prevent a further seizure.'

'One week on and the temperatures are continuing to climb in Sydney.

'Matt's relieved to out of hospital and back at home with his beloved bike -

'not that he'll be riding it for a while.'

I never seen actually seen a helmet split like this before.

It split the outer casing which is a good 10 millimetres thick.

And then the foam which runs throughout the whole helmet is also split.

I cannot see me wearing this helmet again!

The second I hit my head I was out.

From then on it's a big blur.

I definitely got lucky.

The first time I watched the footage it was very hard to watch.

But I do feel like I'm back to normal.

So hopefully when I go back for the follow up CT scan

everything's going to be A-OK.

It may be a cliche, but it's true,

there is nothing Australians like more than a barbecue with a few mates.

And it's one Aussie tradition that Dr Richard Smith,

who's from Swansea, has really got into.

A barbecue is essentially Australian.

I'd like to think my skills have got better since I've been out here

but my friends and colleagues would probably beg to differ.

Dr Richard has been in Sydney for the last six months,

working with the helicopter ambulance service.

Obviously the service here does some added bits on.

For example, the winching and the water rescues,

that no-one in the UK does outside the RAF and coast guard.

So that certainly is an aspect. It's nice to learn new skills.

Sausage?

With millions of people barbecuing every day, not just at home,

but on the thousands of public barbecue sites in parks, beaches

and campsites across Australia, accidents are inevitable.

INDISTINCT VOICE OVER RADIO

We'll be there in about 20 minutes.

Tonight one family's holiday barbie has been ruined -

the barbecue has exploded in a father's face leaving him badly burnt.

Dr Richard and the helicopter team are on the way.

Is there a clinical update on the patient?

The patient has extensive facial, chest and hand burns.

Copy that. Thanks very much.

Extensive.

We've been called out to a gentleman

that has been involve in a gas bottle explosion at a campsite.

Quite some distance from the burns centre,

so we'll go and see what this man's like

and then probably end up taking him to Sydney to the burns centre

so he can be fully treated there.

We have a different technology here,

so all the helicopters here carry blood,

we carry ultrasound machines. We can do a lot more for people pre-hospital.

Good line, good speed. Trees on the right. Check left.

Stand by, steady. Just looking underneath.

You're clear down on the right. Check left. Free to the ground.

Hiya.

He leant down to light the barbecue and it exploded.

He copped a faceful of flame.

Blimey! Did you get thrown by it

or was it just there and it went round you?

Mitchell touched it and it wasn't hot,

so he pressed the button again and the whole thing just exploded

and the barbecue lifted up out of the concrete area

and he just dived on the ground

and ripped his jumper off.

OK. You're feeling cold?

Well, he's not sure.

-He doesn't know if it's a pain or not.

-OK.

-I'm feeling hot in the face and hands.

-Yeah.

The accident has happened on the first day of Mitch Hawes'

camping holiday with his wife and three young sons.

The hands are the worst by the looks of it.

-Yeah.

-OK, fine.

How much pain are you in?

My hands are in a lot of pain.

-My face feels like a fairly severe sunburn.

-OK.

-But it's your hands that are the big problem.

-Mm-hm.

-OK.

-You weren't thrown?

-No, I jumped!

-Nothing hit you.

-No.

And no aches and pains anywhere else?

It's just your hands and your sunburn...

-Yes.

-..as it were.

OK, we'll get your hands dressed while we're waiting for this to go.

So we'll get some Clingfilm on those to keep them nice and clean.

We can probably rest some Clingfilm over the front of your neck.

We want you to keep breathing.

Right, let's get the other hand.

It sounds stupid, but it will start to help the pain.

When you burn yourself, you sort of damage your normal skin, obviously,

and it exposes some of the nerves.

So instead of them being cushioned by skin, they just get exposed

and they're really sensitive to anything,

even air brushing over them.

-No air-con?

-Well, it's a little bit breezy up there,

but it's not too bad if we close the doors.

The concern is he's burnt his hands

and if you get any scar tissue forming that can

affect your function for recovery.

So it's important we take him to a burns centre.

I think he's a bit annoyed his barbecue hasn't happened, but that's life.

Mitch is on his way to the specialist burns unit

at Royal North Shore Hospital in Sydney.

There he'll find out how his quick thinking straight after

the explosion may have prevented his hands being permanently damaged.

Of all the beaches in the world,

Bondi is probably the most closely associated with surfing,

but surfing isn't the only board sport that Australians love.

Over a million Aussies are regularly kick-flipping, grinding

and dropping ramps - that's skateboarding to the rest of us.

But just like surfing, skateboarding takes years to learn,

and it's easy for the overconfident beginner to come unstuck -

especially if they've had a few beers.

At the Ambulance Service Wollongong base, 50 miles

south-west of Sydney, the helicopter team has been called out

to pick up a skateboarding novice who's knocked himself out cold.

It's a 19-year-old who was skateboarding down a hill

way too fast without a helmet on.

He's got a big swelling to his head with his eye closed shut, and the

worry is that he's damaged one of the blood vessels around the brain.

Dr Sarah Coombes is a consultant from Yorkshire,

although she now has Australian citizenship.

I'd always wanted to come and work in Australia,

because emergency medicine as a specialty here came into being

a lot earlier than the UK, so I wanted to come and experience it

and see what was different about it,

and got suckered in and stayed forever.

The teenager who crashed his skateboard is on holiday

with his mates at Moruya,

a small coastal town 70 miles east of the Australian capital, Canberra.

It's 40 below, gumtrees on the left belt clear.

The wardsman is waiting for you.

We're at Moruya Hospital down the south coast,

so we'll just go and have a look at this young man who's come off

his skateboard, see if there's anything I need to do

before we put him in the aircraft.

-OK, no helmet on?

-No.

-OK.

And you're just going too fast downhill and...splat?

Well, apparently I've fallen off my skateboard pretty hard.

I'm not really a skater. I just...

One of my friends had a skateboard, um...

It was a really steep hill, I just thought

I might as well give it a crack.

So you've got a very fine layer of skin off down here, and here.

I guess this is the one that's in the corner of this eye,

so it's around about that area there that is probably equivalent to

a full thickness burn, where you've skinned the top layer of skin off.

-So that's going to need a really good clean-up.

-Mm-hm.

Because Alex Santiago hit his head so hard and lost consciousness,

there is a possibility he may have a bleed on his brain.

The only way to find out is for him to have a CT scan,

and the nearest scanner operating at this time of night is in Canberra.

This is Alex.

It's at this point that Alex reveals there may be another

reason why he fell off his skateboard.

From just having a few beers on the porch...

-HE LAUGHS

-..being in an ambulance and a helicopter.

I'm sure it'll be a nice flight.

It's a three-hour road trip from Moruya to Canberra

and the doctor at the smaller hospital was very nervous

that if something bad was going to happen, it's a long way

until you get to more skilled assistance.

Over the town on my right...

Rescue 26...

You're over the pad on the left. Clear the ground left.

MUMBLED VOICE OVER RADIO

'They're going to scan him

'and then chances are they're going to send him home

'if he scans normal, and 99.9% sure it's going to be normal.

'We will get called to a lot of things like that.'

In the UK, on the whole, within the Home Counties

and within London,

you'll never get sent to a patient like that.

In some of the larger counties, so in Yorkshire you'll get sent to

some medical stuff, just cos it's a lot further from hospital,

but very few jobs that easy.

12 hours after he crashed off his skateboard and tore up his face,

Alex was discharged from hospital in Canberra.

One week on, at a proper skate park in the capital,

no-one is trying anything as radical as the stunt Alex tried

to pull on his borrowed board.

I was unconscious for about three minutes, apparently,

and Becky tried to wake me.

'She was British. She had a British accent.'

She helped me a lot.

She came in and re-dressed my face and did a better job, I think.

Maybe you should try this one.

'I probably will skate again.

'I probably should wear a helmet next time.'

Because I probably would be fine if I wore a helmet.

Earlier, the Ambulance Service helicopter team was scrambled

to an accident involving a holidaymaker

and an exploding barbecue.

Their patient, Mitch, is en route to a specialist burns centre in Sydney.

The burns, at the moment, are dressed with Clingfilm.

Obviously needs looking at by the burns and plastics people.

'Clingfilm is a really good dressing for a burn.'

It's clear, so when you've put it on it means we can examine the burn

without taking it off again, so that reduces the chance of an infection.

Mitch Hawes was cooking on a gas barbecue

at a coastal campsite 120 miles South of Sydney

when it blew up in his face.

Are you nice and comfy?

It could have been a lot worse - Mitch's six year old son was

standing right next to him when it happened.

My little fellow was standing behind me, so, you know...

-Took one for him.

-Yeah, it is lucky that he didn't go any closer.

-Yeah, sure. So did you run straight into the shower?

-Yes, straightaway.

-Good work.

-Yes.

-First, I rolled on the ground, because...

-Well, on fire or what?

-Were you on fire...?

No, but the clothes had melted, but not to my skin.

Getting in the cold shower was the best thing Mitch could have done -

it means he probably won't have to have skin grafts.

Right, so this is Mitchell Hawes, a 35-year-old man, as you see him.

Injuries, essentially, he's got burns to both the palm

and dorsal aspects of his hands,

and he's also got a lot of burn there.

Those are second-degree, reasonably nasty, including the palms as well.

That is just all erythema. It feels like sunburn.

The main issue is his hands.

I'd raised that side, so I must have

gone that way and landed on that side.

Mitch didn't have to have surgery,

but he did have to stay in hospital for several nights.

That meant his family holiday ended almost as soon as it had begun.

Three weeks after the accident and Mitch

and his boys are making up for lost holiday time.

And, Blake, you can hop on the swing.

Take your helmet off.

'After it happened, when I was in the hospital,'

I had a lot of flashbacks of the sound of the gas, like "woof!"

I had a lot of problems with that at night.

I was a bit on edge for a couple of days, but I think

I eventually worked it through my own mind

and came to terms with what had happened.

But I think the test will be when I come to have another barbecue again.

Like a quick, hot flame. Like blue flame.

Which gave me borderline third-degree burns on both hands,

and the face was what they call a flash burn,

so it was a very, very severe sunburn.

That's a good line, good speed, good to descend.

50 below trees on the right. Check left.

The helicopter landed and a British doctor came over and treated me,

'and that was a bit of a shock - I was expecting an Aussie.

'But he was really good.'

He really knew what he was doing.

If Mitch hadn't been wearing a long-sleeved jumper,

he could have ended up with 40% burns to his arms and body.

As it is, he will have to wear pressure bandages on his hands

for several weeks.

The way they are now, they're just at a point where all the dead skin's

peeling from them, and we're just working on keeping

the scarring down, so I have to keep these for 23 hours a day.

Only take them off to have a shower and shave,

and then put them back on, and moisturise them,

and hopefully we'll get away without too much scarring.

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