Episode 3 Helicopter Heroes

RADIO: ..fall from a tree.

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...

Keep 'em coming round.

..they're likely to be British.

And so is the pilot's paramedic and crewmen.

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

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

-RADIO:

-Life Saver 24...

They said they got the bends from coming up too quickly.

From shark attacks on surfing beaches,

to exploding barbecues 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 now?

Now, like hundreds of medics every year,

-he's swapping rainy Britain...

-It's wet.

-It IS wet.

..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's 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.

Are you ready? Can I listen to your heart?

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

Today, with minutes to live,

a drowning sailor is plucked from the sea.

'He knows that's his angel from above.'

A tiny premature baby with breathing difficulties

needs the British Flying Doctor.

We'll put some earmuffs on him, because the helicopter's loud,

and that can be quite distressing for the babies.

And the 76-year-old biker who's crashed off the road.

-PATIENT GROANS

-Sore? Sorry, brother.

Eight out of ten Australians live within a half hour drive of the sea.

That's 18 million people who regard the beach as their playground.

But the coast's a dangerous place.

Around 300 Aussies drown each year.

DISTANT SIREN

It's former Yorkshire lifeboatman John Sheader's job to save them.

He's a crewman on the Life Saver Rescue chopper,

covering Sydney's beaches, including the world-famous Bondi Beach.

'I was in the ambulance and I left Yorkshire about 2005, 2006.'

I always wanted to do search and rescue, helicopters and things,

so it was a natural to move on from that.

John's not the only Brit here.

Former Marine Tony Wood from Brighton is on duty too.

We're on call at the drop of a hat.

From the time we pick up the phone to the time the phone's put down,

we're airborne within three and a half to four minutes.

Today, it's an unusual emergency for John and Tony.

A trawler's run aground.

It's become a new attraction on the Sydney shore

and the crowds are gathering.

The crew's safe, but Life Saver One has been sent

to help the salvage team being sent aboard to refloat the boat.

ON RADIO: Good afternoon.

How are you guys, any update on this?

We wondered what the guy's doing. Like, why is he that close?

How can he be that stupid to get caught there? Amazing.

Salvors want to inspect the hull in case it leaks oil.

And this is the only way they can get aboard.

If this goes wrong, they'll need the Life Saver team.

The rocks mean rescue boats can't get far enough inshore.

Luckily, the salvors are good swimmers

and the boat is still watertight.

RADIO: Yes, Life Saver One, go ahead.

Yes, just got a situation update...

The harbourmaster's in charge and he's a Brit too.

The vessel's in a pretty sound condition.

There is some fuel on board,

but the fuel tanks are solid and sound as well.

So we're confident that if we pull the vessel clear of the rocks,

she'll be good to float, then we'll take her for repairs elsewhere.

And I'm pretty hopeful that we'll make our first attempt

in the early hours tomorrow morning.

The Life Saver chopper is returning to base.

But not every emergency is that simple, or with such a happy ending.

John and Tony operate the winch, dropping a rescue diver,

known locally as "the dope on a rope".

Dozens of people like this shipwrecked yachtsman

owe their lives to them.

It's quite a low rescue there so the downwash of the aircraft is

making it rougher than what it probably is.

I mean, it's still moving about a bit but,

as you can see, there's rocks as well.

You can see the chap in the water there.

With that type of rescue, that's called a snatch rescue.

It's extremely quick.

You basically get up to the patient, the individual,

you assess the size of the individual.

The boat is overturned and the old fellow has just managed to

grab hold of this particular rock.

He's getting washed all over the place but that's...

He's holding on for grim life.

If they're drowning and think they're breathing their last,

they will tend to grab the rescue crewman and can push them under.

That man is grabbing. He knows that's his angel from above.

You bring them out the water about ten foot then you let them

settle down to make sure it is all on correctly

and then you bring them up.

You don't appreciate the strength of the sea

and how unforgiving it really is.

For John, this is a very different coastline to the one

he used to safeguard back home as a volunteer crewman

on the Scarborough Lifeboat.

In Australia they have houses right on the end of the cliff but,

you know, Yorkshire and Filey and everywhere,

they keep falling into the sea.

My first few flying sorties down here, I was thinking,

"Hm, don't they fall in the sea? Because they do in the UK."

But those formidable cliffs

have a lethal attraction for foreign tourists.

This summer, a German walker found herself in terrible danger.

So, they have spotted the young lady, as you can see.

The phone was next to them as well.

That turned out to be extremely fortuitous

because, as you can see,

the gradient there is absolutely straight down.

I think they are 110 foot here

which is one third of the length of the wire

but you don't want the wire

scraping and rubbing against the rocks.

They're just going to bring her up to the top of the cliff, bring

the hook and the person over to the grass then just lower them down.

That's what we call tea bagging.

So, we are just disconnecting her from the hook there

and taking our strop off. And, as you can see, "Thanks very much."

That's the best part of the job.

The waters around Sydney teem with fish

and sea angling is a popular pastime here.

Tony Wood shares the national passion

but at work he sees the risky side of rock fishing.

It's the most dangerous participated sport in Australia out here.

Last year alone I think we had 14 rock fisherman that

lost their lives. Of which we picked up probably eight of them.

So it is a very, very dangerous sport.

Tony knows that, even on his day off, this is no place to relax.

Oh. I lost that one. That was a nice fish.

I have come here purely because it is safer.

To go over there where you see all the waves crashing now,

or further around the headland, it is absolutely dangerous.

There might be a chance that you might get more fish

but basically you have just got to respect the sea

because it will come up

and bite you every time with these rogue waves that one in nine

is not the same as all the other waves that are coming on board.

The team find even those who are equipped to survive

can get into trouble too.

This kayaker has been blown out to sea.

And he is telling him to come away from the kayak.

Come away from the kayak. It's going to be easier.

Otherwise it means he has got to either swim round the kayak

when he's in the water... And, as you can see, he has left the kayak.

He is in the water. Two or three kicks.

And he was absolutely exhausted, this man. Exhausted.

I'm a believer in karma and in the 28 years I was in the Marines,

life was taken, it had to be, that was my job.

And somehow I have come full circle and now I am saving people

and I think that is just a great way of living.

I go to bed now quite peaceful.

In Sydney and the rest of New South Wales,

critically ill babies and children

have their own specialist area ambulance.

It is called NETS.

Dr Victoria Sheward is from London.

She has been working for NETS in Sydney for five months.

Back home in England, I am a children's intensive care

medicine trainee doctor.

I have done several years in paediatric intensive care back home

but the difference is really out here in Australia the distances

are massive and so we rely on helicopters

and fixed-wing small planes to cover the distances to go

and get these very, very unwell children.

Today, Dr Victoria is going to transfer a premature baby

from one hospital to another.

Thank you.

This sounds simple but flying a tiny baby who weighs about the same

as a bag of sugar in a helicopter is potentially very risky.

So what happens now is we just wait for the local staff who have

been looking after the baby for the last few weeks to give us

a really good hand over of how the baby has been

and what the current issues are and things that we need to know.

And then what we will do, is we will get our equipment ready

and get the baby onto our monitoring and I'll examine the baby

and make sure there is nothing else

that we need to do differently or change.

Baby Jackson was born 14 weeks early.

-He is going to come by helicopter.

-Hello.

-Look at him. He's wide-awake.

He is wide-awake, isn't he?

It has been a worrying five weeks for Jackson's mum and dad.

Jackson was born while they were house-sitting for friends.

He has had lung problems but now the doctors think

he is ready to be moved to a hospital closer to home.

The reason that we will be taking him and being very, very careful

on the way is that he has been having those dips

in his oxygen levels still, hasn't he?

So we have put a little drip in his hand so that we can give him

some sugary fluid on the way so that his blood sugar levels don't drop.

Dr Victoria will spend half an hour at Nepean Hospital

moving Jackson into the incubator he will fly in.

Jackson looks great.

There is nothing really that worries me

about his clinical situation at the moment.

He has got a mask on his face, which is helping his breathing.

We will put some earmuffs on him because the helicopter

is extremely loud and that can be quite distressing for the babies.

So, yeah, it's all about getting him onto our system now.

Victoria is one of four British doctors working for NETS.

You know, the more people that want to give looking after babies a go,

like, why not? The more help, the better.

And, to be honest, you guys are very nice too.

OK. You're looking all right, buddy. Good boy.

All right.

We are just putting our CPAP mask onto his nose.

Have a good seal.

He has got quite big nostrils.

They're quite long prongs though, aren't they?

But his nostrils are so big.

He seems very comfortable now that we have changed his mask to

a different shape and we have got a good seal there.

His oxygen levels are good and he looks very comfortable, really.

His breathing is not a problem.

We make sure that we have got everything we need

so that we have got things for all eventuality, really.

We are prepared if he stops breathing.

If he needs help with his breathing, we have got equipment to support him.

And we have got a drip in to give him

any medications that we would need to give him on the way.

Every year, Dr Victoria and the NETS team

make around 1,400 journeys carrying sick babies and children.

It means that specialist doctors and nurses in hospitals

don't have to leave the wards to travel with their patients.

Jackson is travelling fairly well.

Nicole was just making some adjustments

because with the vibrations of the helicopter,

the mask had slightly slipped off his nose

so he wasn't getting the same pressure that he was getting

when he was down on the ground and that was just meaning

that his oxygen levels were a little bit lower than they had been.

At just 37 days old,

baby Jackson has already flown 80 miles in a helicopter.

That's more than most people do in a lifetime.

We always try to give the smoothest ride we can

so it doesn't really matter

what the patient is.

I get a lot out of it knowing you helped speed them

on their way to the right facilities, yes.

Jackson's been cared for during the flight by a British doctor

and at his new hospital there is another Brit waiting to receive him.

I was working in London and I was actually training in paediatrics

and a friend of mine was over in Australia doing NETS and flying

around in a helicopter and a plane and I thought,

"What a fantastic thing to do."

So within about three months I was over here as well.

We have fantastic weather. Quality of life is fantastic as well.

And, you know, the people in Australia

are just wonderful to work with.

This is my bit done.

It's always nice to see them settled into the new place.

When his parents come back home this evening,

they will know that Jackson is nearby, which will be much,

much nicer for them than being all the way down in Nepean.

But Jackson still needs lots more tests.

In the next few days, he will have an eye examination to check

if his vision has been permanently affected by his premature birth.

Although Australia has a reputation as a young country,

like Britain, its population is ageing.

14% of Aussies are aged over 65.

But these Sydney-based pensioners have no intention of slowing down.

When you retire, you find you have got nothing to do

so you join this club and it's just amazing the amount of mates you meet.

A lot of the old blokes... We've got guys at 75.

A lot of them have a problem getting on their bikes

so the young ones - in their 40s and stuff -

they help the older ones on their bikes and help them off.

As long as they get on

and get the balance and take off, they're all right.

Even though these elderly bikers

say they never break the speed limit,

that doesn't guarantee accident-free outings.

Today, one of the gang has skidded off his cruiser on a remote road.

Because of the location and the age of the patient,

the New South Wales Ambulance Service helicopter

has been scrambled.

RADIO: Apparently we have a 75-year-old male

travelling approximately 70K came off onto the bitumen.

Was wearing a helmet.

On-board is British-born doctor Toby Fogg.

He has lived in Australia for ten years and has a young family.

'We go back to England every year or so.

'Their grandparents are there and, you know, they love the trips'

and they themselves have got English passports as well as Australian.

They know Dad is an Englishman. He sounds a bit different.

The accident site is surrounded by electricity pylons

and trees so landing will be difficult.

Yeah, if you're happy, we are happy to bring it in next to that van

just to the north of you.

Hanging this far out of the helicopter is routine for emergency

medical crews in New South Wales but it rarely happens in the UK.

The elderly biker's cruiser

has come out of the crash relatively unscathed.

Now Dr Toby and the team are about to find out what

hitting the tarmac at 45 miles an hour has done to their patient.

Any medical history or medications we need to know about?

He has got a history of emphysema, cardiac bypass 16 years ago.

-Just some gout, hypertension, high cholesterol.

-Nice. OK, thank you.

-Allergy to Bactrim.

-OK.

We were coming along the road here and he just went a little bit...

Drifted a bit too wide on the corner and just came off the bike

and probably skidded about, I don't know, six metres, eight metres

into the gravel and ended up in the dirt there.

Peter? G'day, mate, I'm Toby. I'm one of the doctors. Where does it hurt?

'The English would say I sound Australian,

'the Aussies say I can sound a bit English at times.

'Probably one of the first things you pick up when you move over

'here is those little very Australian colloquialisms.'

-And this way.

-Aargh!

-Sore? Sorry, brother. Keep breathing.

'I suppose, in a way,

'I want to belong rather than stand out as being a pom.'

Wriggle your toes for me. Good man. Did you feel me touching your feet?

All right. You had a helmet on, did you? Open your eyes for me.

He's 76 years of age and he's one of the nicest guys you could ever meet.

You don't want to see this sort of thing happen.

-There seems to be restriction.

-Restriction, yes.

You've probably got a couple of broken ribs so we'll roll along.

I am a bit concerned about his chest injuries.

He's certainly got some broken ribs.

My fear is whether or not he has got a punctured lung as well.

But he's oxygenating well enough at the moment

so we are just going to get him to hospital as soon as we can

and be prepared for any deterioration in flight.

Hopefully that won't happen.

So what have we got?

He had his helmet, he had his leathers.

The helmet is really scratched. Maybe it was a little bit loose

and was partly dislodged when he came off but it was certainly there

so it could be a lot worse.

So, straight to Liverpool Hospital,

which is about eight minutes' flight

and the emergency team will be ready for us when we get there.

Dr Toby is doing an ultrasound scan to check that Peter

doesn't have a collapsed lung.

This is difficult to detect by eye in its early stages

and is potentially fatal.

Although Dr Toby trained in British hospitals,

he doesn't see himself working back in the NHS.

I sweated blood for the NHS, probably four, five years.

'Look, there are aspects of the NHS and I would love to go back

'and work for the London HEMS or one of the other helicopter services.

'Working in one of the major trauma centres would be really interesting.

'But it is a huge upheaval for family.

'I can't foresee that happening at the moment.'

You guys ready? This is Peter McKenzie.

75-year-old chap riding his motorbike about one hour ago.

Came off doing 70. Slid it down on a corner, hit his left-hand side.

Reportedly no loss of consciousness although bystanders said

they couldn't feel a radial pulse initially.

At Liverpool Hospital, Peter has a second ultrasound scan

and there's bad news. He has got internal bleeding.

The black line is some free fluid. Just a trace. That is abnormal.

So it's probably some blood in the abdominal cavity, which is abnormal.

Because he is stable, he will go for some CAT scans.

If he was unstable,

he'd probably go straight to theatre but he is stable so we have

got time to do a CAT scan to see exactly where it is bleeding from.

Peter was travelling at around 40 miles an hour when he crashed.

'I'd say he's been a lucky guy. You know, it's an open road, high speeds.

'If he had been going any faster, it could have been a lot different.'

But Peter wasn't that lucky.

He had nine cracked ribs and a collapsed lung

and spent several weeks in hospital.

He hasn't been out on a motorbike since

and his gang of mates are missing him out on the road.

Away from the major cities, Australia's road system is patchy,

some places only served by dirt tracks.

So helicopters are used for routine hospital transfers

that in the UK would be carried out by road ambulance.

Today, the New South Wales Ambulance Service helicopter

and Scottish doctor David Anderson are flying 40 miles to pick up

a patient with pancreatitis.

She needs some medicine at the moment to support her blood pressure,

which is why she needs a medical escort so we are going to go

pick her up there and take her to the intensive care unit at

Wollongong Hospital.

The flight takes them down the holiday beaches

of the New South Wales coast

to a small hospital in the seaside town of Shoalhaven.

Acute pancreatitis is a pretty common condition where you get

inflammation of the pancreas

It can cause problems with blood clotting

and a number of other things.

It can be a very serious and often fatal condition.

The team's elderly patient needs specialist care closer to Sydney.

We end up doing some very long transfers,

both helicopter and fixed wing,

and it gives you a really good opportunity that you wouldn't get

anywhere else to manage really sick patients in a really

unusual environment for a prolonged time.

-RADIO:

-This is Rescue 26. Arrived Shoalhaven. Thanks. 26.

Valerie Maguire is 79

and suffering from complications caused by a gallstone.

-I'm just going to have a wee feel of your tummy, OK?

-Are you?

Let me know if it hurts when I press anywhere. OK?

Sorry, my hands might be a bit cold.

This hospital is private

and Valerie's care will be funded by an insurance company.

And doctors here have no shortage of equipment.

This is a CT scan of Val's abdomen

so it kind of slices through her like this,

using a spinning X-ray machine and the organ of interest

is the pancreas, which is a kind of indistinct...

It's this kind of vague blob you can see here which the radiologist

reckons is a bit inflamed.

And here is the gall bladder, which has got thickening

and fluid around it so it is likely that she has got

a stone from the gall bladder which has passed down through the pancreas,

which is causing the inflammation.

Which is a common cause of pancreatitis.

Dr David came to Australia via New Zealand

but he's not the only Brit at this hospital.

Expat nurse Pam Mason has been caring for Valerie.

There was, I think, only myself and a couple of others

but at the moment we have got six young doctors come out from the UK.

They came over in July for a year

so I've been inundated with fellow poms now.

-Blood pressure is as low as 75.

-OK.

Valerie was on holiday

with her husband when she developed pains in her abdomen.

A family friend recognised the symptoms of a gallstone.

I just had a talk to the other doctors here.

It looks as though they've done about as much as they can

and they've done all the right stuff but you need to

just have a bit more closer tender loving care at Wollongong, OK?

-OK. Fine.

-Gosh, your hands are bit cold there, aren't they?

Valerie was on holiday

with her husband when she developed pains in her abdomen.

A family friend recognised the symptoms of a gallstone.

-RADIO:

-1945. Thank you, Rescue 26. 6 PNE.

We checked by the coast. It's going to be pretty rough over those hills.

Rescue 26 is flying Valerie to a bigger hospital

in Wollongong, south of Sydney.

It is a short flight but Dr David

will be monitoring his patient carefully.

Pancreatitis can deteriorate very quickly.

'New South Wales is the size of France

'with a population of only seven million,

'so it makes sense to fly someone from a small peripheral hospital to

'a major ICU because this is a disease

'where patients can deteriorate

'quite rapidly and you don't want to be in the back of an ambulance

'in the middle of nowhere if you're going downhill fast.'

She has been unwell for about the last four days with increasing

abdominal pain, malaise, off her food. This morning, went to the GP.

They did some bloods and referred her in. High amylase, high lipase.

A bit of abdominal discomfort.

'Pancreatitis can be very serious

'and she needs that medicine to control her blood pressure.

'I was altering the rate a bit as we went to maintain'

a good blood pressure. She has had a huge amount of fluid.

What happens with pancreatitis is the blood vessels get really leaky

and leak fluid out into the tissues

so she has needed a huge amount of fluid to replace that

and now she needs the medicine to support her blood pressure.

So she is still not out of the woods yet but it is reassuring that

she's been very stable with us and she has stayed in good spirits.

Valerie is immediately taken to intensive care.

The next day, she is sent for surgery.

It is successful and a few days later she goes home.

Newcastle is a two and a half hour drive north from Sydney

and its children's hospital has one of the largest neonatal

intensive care units in New South Wales.

More than 100 babies are brought here

from other hospitals every year.

One of those tiny travelling patients was baby Jackson.

British doctor Victoria Sheward

and the Newborn And Paediatric Emergency Transport Service or NETS

flew him 18 miles from Nepean near the Blue Mountains

so he could be treated nearer home in Newcastle.

One week on and baby Jackson

is having the first of many eye examinations.

Let's just move Jackson around.

Nurse Shirley Graham is carrying out the tests.

She worked for 13 years in the National Health Service in Glasgow

before coming to Oz.

'My husband was always keen to emigrate so he asked me this time'

and I was at a stage where jobs weren't that

secure in the Southern General and I agreed so we came here in 1991.

I have never regretted it. I wish I had come earlier.

Right, my man.

Not very nice. I know.

Like many premature babies, Jackson's eyes may not

develop properly, putting him at risk of blindness.

We are just taking a picture of your red eye.

'We put eye drops in to actually... Sort of, like a pain relief'

and then we dilate the pupil

so that we can get a good window to look through and we also give

the baby some sucrose, oral sucrose, for pain relief

and we put a topical gel on

between the eyeball and the lens of the camera.

Babies 32 weeks less and under have got premature development

of the vessels behind their eyes. So we monitor them

'as soon as they're 28 days of age

'and then every two weeks until the retinas mature.'

That's it. All done. You were very good.

The test shows that, so far,

Jackson's eyes have not been affected.

He's now at home with his mum and dad.

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