0:00:03 > 0:00:05EMERGENCY DISPATCH RADIO
0:00:05 > 0:00:09It's one of the most beautiful but dangerous places on earth.
0:00:09 > 0:00:11My name's Helen. I'm one of the doctors.
0:00:11 > 0:00:14Any pain in here? Any teeth loose or anything like that?
0:00:14 > 0:00:17And when Australians call out the Flying Doctor...
0:00:17 > 0:00:18- PILOT:- Keep coming round.
0:00:18 > 0:00:20..they're likely to be British.
0:00:20 > 0:00:24And so is the pilot, paramedic and crewmen.
0:00:24 > 0:00:27We'll see lots of sharks 200-300 metres out.
0:00:27 > 0:00:30They get the idea when we go like that.
0:00:30 > 0:00:34- RADIO:- 'They're saying they got the bends coming up...'
0:00:35 > 0:00:38From shark attacks on surfing beaches
0:00:38 > 0:00:41to exploding barbecues in the Sydney suburbs,
0:00:41 > 0:00:46these are the Brits who can make the difference between life and death Down Under.
0:01:09 > 0:01:14James Milligan is an NHS consultant working at Leeds General Infirmary.
0:01:14 > 0:01:16How's that tummy pain?
0:01:16 > 0:01:18Now, like hundreds of medics every year,
0:01:18 > 0:01:23he's swapping rainy Britain for a life in the sun.
0:01:23 > 0:01:26We're living right by the ocean. It's a beautiful spot.
0:01:26 > 0:01:28Work's nice and relaxed.
0:01:28 > 0:01:31The atmosphere's great. Life probably couldn't be much better.
0:01:31 > 0:01:35But it's a place where the nearest hospital can be 200 miles away,
0:01:35 > 0:01:38and the wildlife can kill you.
0:01:38 > 0:01:41You ready? Can I listen to your heart?
0:01:41 > 0:01:45Welcome to one of the world's most extreme health services.
0:01:46 > 0:01:49Today - a car crashes on a rural road -
0:01:49 > 0:01:51two teenagers are critically injured.
0:01:51 > 0:01:55Any pain in your chest here, Tye?
0:01:56 > 0:02:00The Flying Doctor comes to the aid of a diabetic bush ranger.
0:02:00 > 0:02:01How long have you been feeling crook for?
0:02:01 > 0:02:03Where is the pain in your leg?
0:02:04 > 0:02:07And a runaway horse leaves its owner in the dust.
0:02:07 > 0:02:09Tell me if this is sore anywhere.
0:02:09 > 0:02:11Open your mouth and breathe.
0:02:18 > 0:02:21If you travel down the coast from Sydney towards Melbourne,
0:02:21 > 0:02:25it isn't long before you find yourself in rural Australia.
0:02:25 > 0:02:28'22 miles away? Sounds about right.'
0:02:28 > 0:02:32And it's here where the Ambulance Service rescue helicopters
0:02:32 > 0:02:34come into their own.
0:02:34 > 0:02:37- PILOT COMMS:- 'Just south of a small town called Buxton.'
0:02:37 > 0:02:41Dr Helen Oliver from London has been working in Australia for a year.
0:02:41 > 0:02:44I'm an anaesthetic registrar.
0:02:44 > 0:02:48And I'm based at the Royal London Hospital in the East End of London.
0:02:48 > 0:02:51I'm in the sixth year of my training.
0:02:51 > 0:02:53The job here's is quite interesting
0:02:53 > 0:02:56in terms of the helicopter work, the retrieval work,
0:02:56 > 0:02:58as well as accident attendance.
0:02:58 > 0:03:01So there's a lot of transferring patients between hospitals.
0:03:01 > 0:03:04Something you don't do in the UK.
0:03:04 > 0:03:07Tonight Dr Helen's on her way to a serious car crash
0:03:07 > 0:03:1070 miles southwest of Sydney.
0:03:10 > 0:03:14Statistics indicate you're twice as likely to die on Australian roads
0:03:14 > 0:03:16than you are in the UK.
0:03:16 > 0:03:19'Sydney control, Rescue 2-6. ETA overhead is one minute.'
0:03:19 > 0:03:23'Large field, just to south there's a farmhouse and tall gum trees
0:03:23 > 0:03:25'- five or six gum trees.'
0:03:25 > 0:03:28We run a 24-hour service, so we do do quite a lot of night missions.
0:03:28 > 0:03:30So night-landings are not that uncommon.
0:03:30 > 0:03:35They're obviously much more challenging than landing somewhere in the daytime.
0:03:35 > 0:03:37The helicopter team is met by a paramedic
0:03:37 > 0:03:41who's done an initial assessment of the two casualties.
0:03:41 > 0:03:42Hey, Phil.
0:03:43 > 0:03:46- How are you, mate? - What have you got?
0:03:46 > 0:03:51The patient he wants Dr Helen to look at is 19-year old Tye Bradney.
0:03:51 > 0:03:54- Hello, how are you?! - Hi! How are you doing?- Very well.
0:03:54 > 0:03:58He was still pinned in the vehicle with his left leg up behind him.
0:03:58 > 0:04:01- I'm going to give his GCS as about 12 at the moment.- Yep.
0:04:01 > 0:04:02TYE?
0:04:02 > 0:04:06- He's actually... A shake. You've got to give him a shake, now.- OK.
0:04:06 > 0:04:09He's got a laceration here that you're going to be fascinated by.
0:04:09 > 0:04:10Right on his tracheae.
0:04:10 > 0:04:11OK, cool.
0:04:11 > 0:04:15- Again, he'll probably be wanting a tube into him.- OK.
0:04:15 > 0:04:17Everything else appears OK.
0:04:18 > 0:04:20Tye and his friend have both suffered serious injuries,
0:04:20 > 0:04:24after their car came off the road and crashed into a telegraph pole.
0:04:24 > 0:04:26Tye, is this sore if I push?
0:04:26 > 0:04:30Tye? My name's Helen. I'm one of the doctors.
0:04:30 > 0:04:32- INITIAL SPEECH INDISTINCT - I'm freezing.
0:04:32 > 0:04:34Yeah, yeah, we'll get you covered up.
0:04:34 > 0:04:36Can I just have a quick look? Open your mouth for me, hon?
0:04:36 > 0:04:40- All right, awesome. Any pain in there? Any teeth loose?- No.
0:04:40 > 0:04:42- Do you remember what happened?- Yeah.
0:04:42 > 0:04:45- I'm freezing, that's what I remember!- Yep?
0:04:45 > 0:04:47Any pain in your chest here, Tye?
0:04:47 > 0:04:50- A little bit, not much. - A little bit.
0:04:50 > 0:04:53- My right one.- The right one.- Yep. I need a blanket!
0:04:53 > 0:04:57- Blanket's on you, sweetie. - Tye, slow down, mate. Slow down.
0:04:57 > 0:04:59TYE GROANS
0:04:59 > 0:05:02He was really uncomfortable. He had a fair bit of pain.
0:05:02 > 0:05:06And he was starting to become a bit confused and agitated.
0:05:06 > 0:05:09Which does make us worry that there might be a head injury there.
0:05:09 > 0:05:12There might be some swelling developing in the brain
0:05:12 > 0:05:14that is causing this confusion.
0:05:14 > 0:05:15So, really for safety -
0:05:15 > 0:05:19obviously, we don't want to have to physically restrain him -
0:05:19 > 0:05:22just giving him a little bit of sedation, which eases the pain...
0:05:22 > 0:05:26Yeah, calms him down, and makes him more comfortable.
0:05:26 > 0:05:28Legs down, Tye.
0:05:28 > 0:05:32- Roll over.- No, no, you got to lie on your back, mate.- Roll over.
0:05:32 > 0:05:35Tye? Tye? Just lie on your back, mate. You'll be right.
0:05:35 > 0:05:36I'm freezing!
0:05:36 > 0:05:39Yeah, we're going to get another blanket and warm you up. I promise.
0:05:39 > 0:05:41So that's 30 ketamine and two of medaz.
0:05:41 > 0:05:43He'll be asleep in a minute.
0:05:43 > 0:05:47Keep still, keep still, keep still...
0:05:47 > 0:05:50Just looking to see if there is any sign of a pneumothorax.
0:05:50 > 0:05:53And what we're looking for is sliding...
0:05:53 > 0:05:55these sort of pearls on a string sign.
0:05:56 > 0:05:59A pneumothorax is a punctured of collapsed lung
0:05:59 > 0:06:00and is potentially fatal.
0:06:00 > 0:06:04It happens when air builds up in the spaces around the lungs
0:06:04 > 0:06:05and stops it expanding properly.
0:06:07 > 0:06:10That looks like there is no pneumothorax on either side.
0:06:12 > 0:06:16While Dr Helen and the medical team take care of Tye, a recovery crew
0:06:16 > 0:06:18attempts to unwrap what's left of his car
0:06:18 > 0:06:20from around the telegraph pole.
0:06:27 > 0:06:30It's amazing that anyone has come out of this wreck alive.
0:06:33 > 0:06:36- Just relax, Tye. - All right, Tye, that's a boy.
0:06:36 > 0:06:40You're doing really, really well. I know you're absolutely frozen.
0:06:40 > 0:06:42We are just going to get you nice and warm now, OK?
0:06:43 > 0:06:46Dr Helen has taken care of Tye's breathing
0:06:46 > 0:06:48by doing what's called an RSI.
0:06:48 > 0:06:51While she sedates him using powerful drugs,
0:06:51 > 0:06:55paramedic Monty puts a tube down the patient's windpipe.
0:06:55 > 0:06:57And then, yes, if you could just try and keep it in line,
0:06:57 > 0:06:59that would be great.
0:06:59 > 0:07:02This is a procedure normally carried out in hospital
0:07:02 > 0:07:05and it takes a great deal of skill to do it in the middle of a field
0:07:05 > 0:07:07by the light of a head torch.
0:07:07 > 0:07:09Well, basically, Tye had symptoms of a head injury
0:07:09 > 0:07:12and was quite confused and was starting to get quite combative
0:07:12 > 0:07:17so obviously he wouldn't be safe for a transfer in the helicopter.
0:07:17 > 0:07:21So, given that and the possibility he has got pelvic injuries,
0:07:21 > 0:07:25possibly a femoral injury as well, we decided to put him off to sleep
0:07:25 > 0:07:27and secure his airway.
0:07:27 > 0:07:31He also has quite a deep laceration just to the side of his trachea
0:07:31 > 0:07:33so, again, just to be safe,
0:07:33 > 0:07:37we thought we would just drift him off to sleep and just get control.
0:07:45 > 0:07:46During the transfer,
0:07:46 > 0:07:50we are continuously monitoring his pulse and his blood pressure,
0:07:50 > 0:07:54his oxygen levels, his carbon dioxide levels, just making sure
0:07:54 > 0:07:58they're all optimal and stable and then I'm sort of continuously
0:07:58 > 0:08:01giving him small amounts of pain relief and small amounts of sedation.
0:08:01 > 0:08:03Basically ensuring he stays fast asleep
0:08:03 > 0:08:05and comfortable throughout the whole transfer.
0:08:05 > 0:08:10There are five major trauma centres in the Sydney area and we took him
0:08:10 > 0:08:13to Liverpool, which is one of the five.
0:08:13 > 0:08:16And that is in the southwestern suburb of Sydney area.
0:08:18 > 0:08:21OK, so this is Tye Bradney. He is 19 years old.
0:08:21 > 0:08:24He was ejected through the windscreen, partially.
0:08:24 > 0:08:27Left leg was pulled right out behind him
0:08:27 > 0:08:31so possible injury to the left pelvis and hip. A deep one to the head.
0:08:31 > 0:08:34He has also got quite a deep laceration just lateral
0:08:34 > 0:08:37to his trachea but looks like there is no involvement of any deep
0:08:37 > 0:08:39structures or any tracheal involvement.
0:08:39 > 0:08:4140 but he is getting 15.
0:08:43 > 0:08:46At Liverpool Hospital, Dr Helen hands over to fellow
0:08:46 > 0:08:49British doctor Rick Wheatley.
0:08:49 > 0:08:54It turns out they went to university together in Newcastle upon Tyne.
0:08:54 > 0:08:58When the patient arrives, my responsibility mainly is airway
0:08:58 > 0:09:02and breathing and I am also here to make sure that he can be
0:09:02 > 0:09:06safely transferred from here to the CT scanner and back.
0:09:06 > 0:09:09At the moment he is ventilating nicely.
0:09:09 > 0:09:11Still on the transport of ventilator.
0:09:11 > 0:09:14And there's another Brit doctor on the trauma team.
0:09:14 > 0:09:18Amy Talbot is from Hull and has been working in Australia for 18 months.
0:09:18 > 0:09:20When traumas come in,
0:09:20 > 0:09:22we can do quick bedside ultrasound scans to look for any
0:09:22 > 0:09:25fluid in the tummy, any air in the lungs or any fluid round the heart.
0:09:25 > 0:09:30This is a big trauma hospital so we get to see a lot of different things
0:09:30 > 0:09:33here, which I wouldn't have seen and didn't see working back in the UK.
0:09:33 > 0:09:36They are used to us now. Yeah.
0:09:36 > 0:09:39Half the staff here are Brits so there's a lot of different
0:09:39 > 0:09:43accents so they always get confused with where I'm from.
0:09:43 > 0:09:45At the moment that's great.
0:09:45 > 0:09:48Once you have got your line in and we've got bloods on the way,
0:09:48 > 0:09:49let's go for a roll.
0:09:49 > 0:09:53The trauma team have done their primary and their secondary survey.
0:09:53 > 0:09:55Basically assessed head to toe,
0:09:55 > 0:09:58ABCs and so on and treated anything they have found.
0:09:58 > 0:10:01He has had a trauma series of x-rays
0:10:01 > 0:10:04and they are just about to take him now to CT scan to do basically
0:10:04 > 0:10:10a top to toe scan just to have a look and see what's going on.
0:10:10 > 0:10:13They are also going to check out the wound in the neck just to make
0:10:13 > 0:10:16sure there is nothing going on that we couldn't see.
0:10:16 > 0:10:19But he has been very stable, actually, all throughout
0:10:19 > 0:10:21so hopefully it will be a good outcome.
0:10:22 > 0:10:24OK, so we'll have the scan and...
0:10:26 > 0:10:32The CT scanner is used to get a very detailed 3D image of Tye's body.
0:10:32 > 0:10:35This will confirm if he has broken his pelvis
0:10:35 > 0:10:38or if the wound on his neck has punctured his windpipe.
0:10:38 > 0:10:41The only way we will make him unstable really now is by trying to
0:10:41 > 0:10:45do something a bit too quickly and pulling something out.
0:10:45 > 0:10:48He has remained stable throughout the transfer so far
0:10:48 > 0:10:50and we need to find out what images
0:10:50 > 0:10:54we've got in the CT scanner so we see what injuries he has got
0:10:54 > 0:10:58and therefore what health monitoring or surgery he might need from there.
0:10:59 > 0:11:03Tye will remain sedated for the next few hours.
0:11:03 > 0:11:061,300 Australians die on the roads every year so he's been lucky.
0:11:08 > 0:11:11When he wakes up he will learn what happened to his friend who
0:11:11 > 0:11:13was in the car with him when he crashed.
0:11:19 > 0:11:22Each day, the pilots who fly Careflight's doctors and nurses
0:11:22 > 0:11:26around the Northern Territory land their planes on remote airstrips.
0:11:31 > 0:11:34They are taking vital medical care to the most sparsely populated
0:11:34 > 0:11:35areas of Australia.
0:11:38 > 0:11:42You could fit five Great Britains inside the Northern Territory
0:11:42 > 0:11:45yet only 220,000 people live here.
0:11:47 > 0:11:50That's the same as the population of Southampton.
0:11:55 > 0:11:58Dr Sarah McNeilly is a trainee anaesthetist from London.
0:11:59 > 0:12:01She's is spending six months
0:12:01 > 0:12:05working for Careflight in the Northern Territory.
0:12:05 > 0:12:08At home I work in a big hospital that has pretty much
0:12:08 > 0:12:14all the medical facilities that we need and I have consultant support
0:12:14 > 0:12:20within 15, 20 minutes if I need it or I am directly supervised.
0:12:20 > 0:12:22Which is pretty much the direct opposite to here.
0:12:22 > 0:12:25Today, Dr Sarah and nurse Janine Hawkes are flying to
0:12:25 > 0:12:31an aboriginal community 130 miles to the southwest of Darwin.
0:12:31 > 0:12:37A very small community to pick up a gentleman who is generally unwell.
0:12:37 > 0:12:39He has multiple health problems
0:12:39 > 0:12:43and seems to have deteriorated today in his condition.
0:12:43 > 0:12:46So we are going out there to retrieve him
0:12:46 > 0:12:48into the Royal Darwin Hospital.
0:12:48 > 0:12:52It's quite a distance for them to travel by road and it is
0:12:52 > 0:12:56probably the safest and quickest for us to go and retrieve him.
0:13:00 > 0:13:02- Thank you very much.- Clear door.
0:13:05 > 0:13:09It is typical. It is fortunate we have got a sealed strip sometimes
0:13:09 > 0:13:13when we go to some, you know, very rough strips, dirt strips,
0:13:13 > 0:13:15which in the wet season can get quite muddy
0:13:15 > 0:13:17but, as you can see, it's very isolated.
0:13:17 > 0:13:19I don't think even we have mobile reception.
0:13:19 > 0:13:21The patient is a bush ranger
0:13:21 > 0:13:25and has been brought to the air strip from the local health clinic.
0:13:25 > 0:13:28He's got quite severe ulcers on his heels.
0:13:28 > 0:13:31He's got complications from diabetes.
0:13:31 > 0:13:37- Whereabouts is the pain in your leg? - From here down.
0:13:37 > 0:13:39When does the pain in your chest come on?
0:13:39 > 0:13:41Is it when you are sitting in bed doing nothing, or...?
0:13:41 > 0:13:44Yeah, when I'm getting all the other pains now.
0:13:44 > 0:13:48- Uh-huh. But you have been taking your insulin still?- Yeah.
0:13:48 > 0:13:49James lives here.
0:13:49 > 0:13:53He also works here as a ranger but he came to us
0:13:53 > 0:13:57this morning for some help because of pain.
0:13:57 > 0:14:00How long have you been feeling crook for?
0:14:00 > 0:14:03Aboriginal people are three or four times more likely to
0:14:03 > 0:14:07develop diabetes than the rest of the population.
0:14:07 > 0:14:11I do all of the investigations, call the doctor in Darwin and then
0:14:11 > 0:14:14the doctor and I make a decision what's the best
0:14:14 > 0:14:17treatment for James and then it was decided that he needed to be
0:14:17 > 0:14:20transferred to Darwin and that's when Careflight come on board
0:14:20 > 0:14:24and then we make a plan and a time for them to pick him up.
0:14:24 > 0:14:27He just might need a little bit of assistance coming up the stairs,
0:14:27 > 0:14:29as steady as he feels.
0:14:29 > 0:14:32- I'm just going to turn the oxygen on.- Sure.
0:14:33 > 0:14:35Good man.
0:14:35 > 0:14:39James May has already had a toe amputated due to his diabetes.
0:14:39 > 0:14:42The pain in his foot has got progressively worse over
0:14:42 > 0:14:46the last three weeks and he has ulcers on his heel.
0:14:46 > 0:14:50Diabetes is pretty common amongst the indigenous population.
0:14:50 > 0:14:53People eventually will develop complications from diabetes.
0:14:53 > 0:14:57People end up with kidney failure and problems with their hearts
0:14:57 > 0:15:02and problems with their feet and their nerves and their eyes.
0:15:02 > 0:15:05All these things are pretty common up here.
0:15:05 > 0:15:09- Yeah, you take it easy. One step at a time.- Good leg first.
0:15:13 > 0:15:16It would take at least four and a half hours by road and, this time
0:15:16 > 0:15:20of year, with the rain, the roads are very muddy and bumpy and very
0:15:20 > 0:15:22difficult to get through
0:15:22 > 0:15:24so we could encounter problems on the way anyway
0:15:24 > 0:15:28so it's really only a 40 minute flight from Darwin to here
0:15:28 > 0:15:31so we really couldn't do our work without them.
0:15:31 > 0:15:33How much is in the bag?
0:15:33 > 0:15:37We've probably got 400 left.
0:15:37 > 0:15:39Can we give all of that, like, stat?
0:15:40 > 0:15:43The temperature is over 40 degrees in the aircraft
0:15:43 > 0:15:44and it's extremely humid
0:15:44 > 0:15:49but heat is not the only thing that Dr Sarah has had to get used to.
0:15:49 > 0:15:50Lots of the patients laugh at me
0:15:50 > 0:15:54when I have a bit of a freak out about the local wildlife sometimes.
0:15:57 > 0:16:01Because I am not used to large flying things and cockroaches and things.
0:16:04 > 0:16:07- AEROPLANE INSTRUMENTS: - '50, 40, 30, 20, 10.'
0:16:11 > 0:16:15The patient did actually deteriorate their condition along the way.
0:16:15 > 0:16:19The patient is transported into the Royal Darwin Hospital now
0:16:19 > 0:16:23with Sarah and the paramedics and will be handed over to
0:16:23 > 0:16:26the emergency department so they are in good hands.
0:16:28 > 0:16:32James, how are you going? How is that foot? How's that pain in the foot?
0:16:32 > 0:16:36- A little.- Still there. Is it any better at all?- A little bit.
0:16:36 > 0:16:37A little bit. OK.
0:16:41 > 0:16:45- Right foot?- Yes.- He has got diabetic ulcers, has he?- Yes.- On both feet?
0:16:45 > 0:16:46Yes, but right is worse than left
0:16:46 > 0:16:50and I think he is probably septic from his right foot ulcer.
0:16:50 > 0:16:53Good afternoon. I'm Sarah, I'm one of your Careflight registrars.
0:16:53 > 0:16:59So, this is James. He is 58. He has been crook for about three weeks.
0:16:59 > 0:17:03He had a course of antibiotics that finished a couple of weeks ago
0:17:03 > 0:17:08from a clinic where he is usually seen for his right foot ulcer.
0:17:08 > 0:17:10He has got ulcers on his left... Both heels.
0:17:10 > 0:17:12And he has had toes amputated in the past.
0:17:12 > 0:17:15The right is much worse than the left.
0:17:15 > 0:17:17The last three days, it has been much worse.
0:17:17 > 0:17:19He was brought in the clinic today by his wife cos
0:17:19 > 0:17:22he is just debilitated by this foot.
0:17:22 > 0:17:25James, take care of yourself, OK? These guys will...
0:17:25 > 0:17:28- Why, where are you going? - I'm off now.- All right.
0:17:28 > 0:17:30But you have got the whole of ED here to look after you, OK?
0:17:30 > 0:17:33- And they'll take very good care of you.- Thanks for everything.
0:17:33 > 0:17:35Not at all. It was our pleasure.
0:17:41 > 0:17:45James's right foot was so badly infected that two days after
0:17:45 > 0:17:48Dr Sarah left him at Darwin Hospital, surgeons had to operate.
0:17:53 > 0:17:55He was in an induced coma for several days.
0:17:58 > 0:18:00But two months on, he's recovering
0:18:00 > 0:18:03and working hard to get his diabetes under control.
0:18:05 > 0:18:08This is pretty good. Take a look. Pumpkin and green peas.
0:18:10 > 0:18:16I think I've had diabetes for the last, oh, four or five years.
0:18:16 > 0:18:20And it is sort of got on top of me, you know? Just being busy working
0:18:20 > 0:18:24and not looking after what I was eating, you know?
0:18:24 > 0:18:29I lost about seven kilos since I've been here and the food is great.
0:18:29 > 0:18:33But there is a massive change that James is having to cope with.
0:18:33 > 0:18:36His leg had to be amputated below the knee.
0:18:36 > 0:18:38No good reacting to it cos it's not going to help me
0:18:38 > 0:18:41bring my leg back and all that.
0:18:41 > 0:18:44Just face facts and just get on with life, I suppose.
0:18:44 > 0:18:46You could say I was dealt a raw card
0:18:46 > 0:18:51but it's all down to looking after yourself
0:18:51 > 0:18:53and how you are living and things like that
0:18:53 > 0:18:58but I was brought up rough as guts and did the things Aussie
0:18:58 > 0:19:02kids done, running around in mud, larking and all that sort of stuff.
0:19:02 > 0:19:04I love my job.
0:19:04 > 0:19:09I love the outdoors and fishing and camping but this having
0:19:09 > 0:19:12one leg missing is not going to stop me doing that sort of thing.
0:19:12 > 0:19:15James is slowly learning to stand without his right leg
0:19:15 > 0:19:17but it will be a long haul.
0:19:17 > 0:19:21I think I've been a good patient. I've got a gold star over there
0:19:21 > 0:19:23- for being a good boy. - HE LAUGHS
0:19:23 > 0:19:24So, yeah, doing my rehab
0:19:24 > 0:19:28and all that and just hopefully maybe in a month or two or
0:19:28 > 0:19:30a couple of weeks, I hope to get out of here
0:19:30 > 0:19:35and go home to my actual stump's fitting of my prosthetic leg.
0:19:37 > 0:19:40James hopes that once he can walk on a prosthetic leg
0:19:40 > 0:19:43he'll be able to go back to work as a manager in the ranger service.
0:19:52 > 0:19:54Ever since the first settlers arrived,
0:19:54 > 0:19:57the horse has been part of life down under
0:19:57 > 0:20:00and, every weekend, thousands still climb into the saddle.
0:20:00 > 0:20:04But more than 300 Australians are killed or seriously injured
0:20:04 > 0:20:06each year in riding accidents.
0:20:07 > 0:20:09RADIO CHATTER
0:20:12 > 0:20:15And today the Ambulance Service Rescue Helicopter is heading west,
0:20:15 > 0:20:17out of Sydney into horse-country.
0:20:19 > 0:20:23On board is A&E consultant Toby Fogg, who trained in the UK
0:20:23 > 0:20:26but moved to Australia ten years ago.
0:20:26 > 0:20:28When I came out here and heard about Careflight
0:20:28 > 0:20:32and the helicopter service here in New South Wales, I knew
0:20:32 > 0:20:35I wanted to go and work for them for six months as a registrar
0:20:35 > 0:20:37and soon after I started there,
0:20:37 > 0:20:40I realised I wanted to do this long-term as a consultant as well.
0:20:40 > 0:20:43This is truly the best job in the world, in my eyes.
0:20:47 > 0:20:50The New South Wales air ambulances are built for speed
0:20:50 > 0:20:53and their twin jet engines can easily spook horses.
0:20:55 > 0:20:57This is not an ideal landing site
0:20:57 > 0:21:01and Dr Toby has limited information about his patient.
0:21:01 > 0:21:03There may be a head injury, they may be unconscious,
0:21:03 > 0:21:05their breathing may be inadequate.
0:21:05 > 0:21:08They may have a neck injury, they may have, you know, chest injuries,
0:21:08 > 0:21:10belly injuries. So I am thinking,
0:21:10 > 0:21:14"Well, what am I going to have to do for each of those things?"
0:21:17 > 0:21:21I know I have got the kit but what are going to be my priorities
0:21:21 > 0:21:23and, you know, what is the environment going to be like
0:21:23 > 0:21:25in which we are landing?
0:21:25 > 0:21:27Now clear of the trees behind.
0:21:29 > 0:21:34Seasoned horsewoman Kerryn Valeontis was cantering down a dirt track
0:21:34 > 0:21:37when her horse threw her, fell and rolled onto her.
0:21:38 > 0:21:42And you didn't lose consciousness? And you remember everything?
0:21:42 > 0:21:46- Have you got much of a headache just now?- No, it's fine, thank you.- OK.
0:21:46 > 0:21:48Kerryn's daughter and husband have been with her
0:21:48 > 0:21:50since soon after the fall.
0:21:50 > 0:21:53Local paramedics have put her on a spinal board in case
0:21:53 > 0:21:56she has damaged her back.
0:21:56 > 0:21:58Just open your mouth and breathe.
0:22:00 > 0:22:01She landed on her face.
0:22:03 > 0:22:07She may have some facial injuries but she didn't lose consciousness.
0:22:07 > 0:22:10A little bit of tenderness on the right side of her chest.
0:22:10 > 0:22:13I was concerned because of the pain she has got in her neck
0:22:13 > 0:22:15and her upper back, whether she has a spinal injury.
0:22:15 > 0:22:19So there is a reluctance to drive these people on extensive road trips.
0:22:21 > 0:22:25Rescue 23 is equipped with the latest ultrasound machine, which
0:22:25 > 0:22:29allows Dr Toby to look for injuries before Kerryn gets to hospital.
0:22:30 > 0:22:32- RADIO:- Copy that. We'll see you then.
0:22:33 > 0:22:38- RADIO:- ETA 10 minutes.- That's right. - No trouble. Thank you.
0:22:38 > 0:22:42It's only a 10 minute flight to one of the city's major trauma
0:22:42 > 0:22:46centres, a journey that would take four times as long by road.
0:22:48 > 0:22:51Over the next few hours, doctors at Westmead will find out
0:22:51 > 0:22:54if Kerryn's fall has caused lasting damage.
0:23:01 > 0:23:03I felt my neck snap and I thought,
0:23:03 > 0:23:07"Oh, what have I done? What have you done?"
0:23:07 > 0:23:10A bit of fear actually because, you know,
0:23:10 > 0:23:12you don't want to break your neck.
0:23:12 > 0:23:14I was just in lots of pain and wondering,
0:23:14 > 0:23:18"Should I move? Should I not move? What should I do? Oh, God."
0:23:19 > 0:23:21Kerryn's had a lucky escape.
0:23:21 > 0:23:24In Australia, horses are involved in more deaths
0:23:24 > 0:23:28than sharks, snakes, spiders and crocodiles put together.
0:23:29 > 0:23:33I was just very impressed with how many people came to the aid
0:23:33 > 0:23:35and all the teams and the backup and everything.
0:23:35 > 0:23:37It was just very impressive.
0:23:37 > 0:23:40It didn't cross my mind whether I had medical insurance for that
0:23:40 > 0:23:42and all that sort of thing. That has come later.
0:23:45 > 0:23:47Luckily, Kerryn had enough insurance
0:23:47 > 0:23:50to cover the medical bill for her accident.
0:23:52 > 0:23:55- They say when you fall off you should get straight back on.- Yes.
0:23:55 > 0:23:59Yes, they do. I just don't bounce any more like I used to.
0:24:02 > 0:24:05Kerryn is no rush to get back in the saddle
0:24:05 > 0:24:08but she says horses will always be a big part of her life.
0:24:17 > 0:24:21Australia's coastal waters teem with fish
0:24:21 > 0:24:22and the famous Sydney Fish Market
0:24:22 > 0:24:27is one of the best places to buy seafood in the country.
0:24:27 > 0:24:29There's everything here, from common flowerpot,
0:24:29 > 0:24:34a cod to you and me, to inkers, the Aussie nickname for squid.
0:24:37 > 0:24:40But filling the fish stalls is a dangerous job.
0:24:40 > 0:24:43One study found Aussie fishermen were 18 times more likely
0:24:43 > 0:24:46to die at work than those with jobs on shore.
0:24:50 > 0:24:52Today, another fisherman is missing
0:24:52 > 0:24:55and at their Newcastle base 100 miles north of Sydney,
0:24:55 > 0:24:59the crew of the Westpac Rescue Helicopter has been scrambled.
0:24:59 > 0:25:03There is always the hope that you're going to find someone alive.
0:25:03 > 0:25:05Realistically, if he was meant to be back at midnight,
0:25:05 > 0:25:08he has been in the water for a long time, eight hours.
0:25:08 > 0:25:09'You are fearing the worst
0:25:09 > 0:25:13'but there is always that element of hope that we might be lucky.'
0:25:13 > 0:25:16Paramedic Dave Cheswick moved to Australia after nine years
0:25:16 > 0:25:18working with the London Ambulance Service.
0:25:20 > 0:25:23Off the coast of the UK, the fisherman would stand little
0:25:23 > 0:25:27chance of survival but, with sea temperatures nudging 24 Celsius
0:25:27 > 0:25:30today, there's a real chance he'll be found alive.
0:25:31 > 0:25:34'If we do get him and he is alive then just how we are going to get him
0:25:34 > 0:25:37'onto the helicopter, making sure in my mind that we have got all the
0:25:37 > 0:25:41'equipment ready to actually help him out if he needs medical attention.'
0:25:43 > 0:25:46The man's disappeared while netting for prawns.
0:25:46 > 0:25:47Dave and his crewmates know
0:25:47 > 0:25:49the tide is likely to have taken him out to sea.
0:25:51 > 0:25:56CHATTER OVER INTERCOM
0:26:01 > 0:26:03Eventually, they spot an object in the water.
0:26:03 > 0:26:06It is the missing fisherman but it's too late.
0:26:10 > 0:26:13Paramedic Dave's medical skills will not be needed today.
0:26:13 > 0:26:17Volunteers from the local surf rescue team will recover the body.
0:26:18 > 0:26:22Westpac 2 returns to base in the worst possible circumstances.
0:26:24 > 0:26:27We did find it a patient which, I guess, in some ways
0:26:27 > 0:26:29gives closure to the family. Very tragic.
0:26:29 > 0:26:33As I say, we would loved to have been...the patient been alive.
0:26:33 > 0:26:36But it might be some comfort that we have actually found
0:26:36 > 0:26:37the patient for the family.
0:26:45 > 0:26:4670 miles southwest of Sydney,
0:26:46 > 0:26:51the teenager pulled out of a wrecked car on an isolated rural road
0:26:51 > 0:26:54has had life-saving treatment from British doctor Helen Oliver.
0:26:54 > 0:26:56All right, awesome. Any pain in there?
0:26:56 > 0:26:59- Any teeth loose or anything like that?- No.
0:26:59 > 0:27:03Tye Bradney was flown to the trauma centre at Liverpool Hospital.
0:27:07 > 0:27:1136 hours later, Tye is recovering on the intensive care ward.
0:27:14 > 0:27:17There was only four things, wasn't there? Or five?
0:27:17 > 0:27:20I've got endless amounts of stitches all over my body,
0:27:20 > 0:27:22through my feet, knees. I got holes in my knees.
0:27:23 > 0:27:28Bruises all up my back and gammy kidneys and all that.
0:27:28 > 0:27:29My face, as you can see.
0:27:31 > 0:27:35They said if it has 2cm higher or lower it would have
0:27:35 > 0:27:38cut my jugular and I would have bled to death.
0:27:38 > 0:27:41Tye was in the car with his best friend and flat mate.
0:27:41 > 0:27:44As I said, my mate is the worst one, do you know what I mean?
0:27:46 > 0:27:50He is still in a coma. He's got a punctured lung and some broken ribs.
0:27:54 > 0:27:56Everyone ready. Ready, steady, roll.
0:27:58 > 0:28:01Ready, steady, down. Lovely.
0:28:03 > 0:28:07He is very, very lucky. Just having seen now, sort of,
0:28:07 > 0:28:10the pictures from the scene of the crash, which I didn't see
0:28:10 > 0:28:14initially, I had just been told, yeah, he is incredibly lucky.
0:28:14 > 0:28:17It's amazing, actually, that he has come away
0:28:17 > 0:28:18with as little injury as he has.
0:28:21 > 0:28:23And it wasn't just Tye who was lucky.
0:28:23 > 0:28:28His friend came out of his coma and his only injury is a broken arm.
0:28:28 > 0:28:31Both of them are now recovering at home with their families.
0:28:38 > 0:28:42Subtitles by Red Bee Media Ltd