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. Any pain in there?
0:00:11 > 0:00:14Any teeth loose or anything like that?
0:00:14 > 0:00:16And when Australians call out the flying doctor,
0:00:16 > 0:00:20they are likely to be British.
0:00:20 > 0:00:24And so is the pilot, paramedic and crewman.
0:00:24 > 0:00:26We'll see lots of sharks, 200 or 300 metres out.
0:00:26 > 0:00:29I think they get the idea when we go like that.
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 > 0:00:44these are the Brits who can make the difference
0:00:44 > 0:00:46between 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, then?
0:01:16 > 0:01:18Now, like hundreds of medics every year,
0:01:18 > 0:01:19he's swapping rainy Britain...
0:01:19 > 0:01:21- It's wet.- It is wet.
0:01:21 > 0:01:23..for a life in the sun.
0:01:23 > 0:01:25We're living right by the ocean.
0:01:25 > 0:01:28It's a beautiful spot. Work's nice and relaxed.
0:01:28 > 0:01:31The atmosphere is 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 > 0:01:39- and the wildlife can kill you. - Are you ready?
0:01:39 > 0:01:41Can I listen to your heart?
0:01:41 > 0:01:45Welcome to one of the world's most extreme health services.
0:01:46 > 0:01:51Today, sharks bring terror to Australia's beaches.
0:01:51 > 0:01:53He just kept biting as he went down.
0:01:53 > 0:01:57The heatwave leaves one tiny Aussie in need of rescue.
0:01:57 > 0:02:00This baby's already been given quite a lot of fluids,
0:02:00 > 0:02:02so you'd normally expect a response.
0:02:03 > 0:02:07And a building worker is hit in the face by his pneumatic drill.
0:02:07 > 0:02:09It's a decent implement that's hit him
0:02:09 > 0:02:11with a fair bit of pneumatic force behind it.
0:02:25 > 0:02:28The coastal waters off Australia are home to some of
0:02:28 > 0:02:30the most dangerous creatures on earth,
0:02:30 > 0:02:32perhaps most famously, the shark.
0:02:36 > 0:02:38The best way to spot them is from the air,
0:02:38 > 0:02:42so every summer, the Life Saver Rescue Helicopter in Sydney
0:02:42 > 0:02:43goes out on shock patrol,
0:02:43 > 0:02:47ready to clear the beaches at a moment's notice.
0:02:47 > 0:02:48During the summer months,
0:02:48 > 0:02:52we tend to go out every day and just patrol up and down the beach,
0:02:52 > 0:02:53and if we see a shark
0:02:53 > 0:02:57and we think that it might endanger the public, we can say,
0:02:57 > 0:02:59you've got a three metre hammerhead
0:02:59 > 0:03:01only 60 metres at the back of your break.
0:03:02 > 0:03:05We're hovering possibly 50 feet above them
0:03:05 > 0:03:06and pointing at the water.
0:03:06 > 0:03:10Then I think they get the idea when we go like that.
0:03:10 > 0:03:12Brit Tony Wood is a former Royal Marine
0:03:12 > 0:03:16and he's done this job for ten years, but you won't catch him being
0:03:16 > 0:03:21winched into the sea, especially when there are sharks around.
0:03:21 > 0:03:22Personally, I wouldn't go in the water,
0:03:22 > 0:03:26but my rescue crewmen do, and they're aware of what they're going into.
0:03:26 > 0:03:28They're brave kids.
0:03:31 > 0:03:35I came here 16 years ago with the impression that every time you
0:03:35 > 0:03:38jumped in the water there would be a shark ready to eat you.
0:03:38 > 0:03:39We have had shark attacks.
0:03:39 > 0:03:41I have been to two in the time I have been on the company,
0:03:41 > 0:03:46and we have actually responded to five in the time I have been here.
0:03:49 > 0:03:53But today, Mike's helicopter team is responding to another, and it sounds serious.
0:03:55 > 0:03:57'This is an Nova 96.9.
0:03:57 > 0:04:00'There'll be no swimming on Mid North Coast beaches for 24 hours
0:04:00 > 0:04:03'after a shark attack south of Port Macquarie.'
0:04:03 > 0:04:06220 miles up the coast north of Sydney,
0:04:06 > 0:04:09the rescue helicopter team's been scrambled.
0:04:09 > 0:04:12A man's been attacked by a shark.
0:04:12 > 0:04:14If we don't see a shark along here somewhere...
0:04:16 > 0:04:18...I promise things.
0:04:20 > 0:04:2329-year-old Luke Allan was surfing in an isolated bay
0:04:23 > 0:04:26near Port Macquarie when he was attacked.
0:04:27 > 0:04:30He was sitting on it out the back waiting for a set to come in
0:04:30 > 0:04:34and when it hit him and knocked him off and took a couple of shots at him,
0:04:34 > 0:04:37he managed to get the tip of his board and knock it down on the shark's head.
0:04:37 > 0:04:43Straightaway I ran up and got my uncle to call the ambulance.
0:04:45 > 0:04:47The shark has taken a big chunk out of Luke's thigh
0:04:47 > 0:04:52and his hand is badly mauled. He may lose two fingers.
0:04:52 > 0:04:55The paramedics we fly with are well trained to deal with
0:04:55 > 0:04:57that at-the-scene care
0:04:57 > 0:05:00and the whole idea behind it is that we get them as quickly
0:05:00 > 0:05:04as we can to the place where they can get higher levels of care.
0:05:04 > 0:05:06The nearest trauma centre is in Newcastle,
0:05:06 > 0:05:08100 miles north of Sydney.
0:05:08 > 0:05:11It's a journey that would take three hours by road.
0:05:14 > 0:05:16In the next few hours, Luke will find out
0:05:16 > 0:05:19if surgeons can save his mutilated fingers.
0:05:22 > 0:05:28'Now, from the WSFM newsroom, Sydney's most comprehensive FM news.
0:05:28 > 0:05:30'Two beaches in Sydney's north have been closed
0:05:30 > 0:05:34'because of a shark which has taken a chunk out of a lifeguard's surfboard.'
0:05:34 > 0:05:35Just two days later
0:05:35 > 0:05:39and a popular surfing beach just north of Sydney is closed.
0:05:40 > 0:05:43There's been another close encounter with a shark.
0:05:43 > 0:05:47This time, the victim isn't taken to hospital.
0:05:47 > 0:05:49In fact, he doesn't even realise he's been attacked
0:05:49 > 0:05:52until he's back on dry land.
0:05:52 > 0:05:55As I went to go up the wave, I just felt a big hit on the board,
0:05:55 > 0:05:58and it knocked me forward and then it kind of dragged.
0:05:58 > 0:05:59Eventually, I've come up.
0:05:59 > 0:06:02That's when I noticed the bottom of my board had
0:06:02 > 0:06:06this big half of the jaw mark, so it would have gone
0:06:06 > 0:06:08the whole way round if it had got its jaw on.
0:06:08 > 0:06:10My feet would have been on the other side,
0:06:10 > 0:06:14and one would have been here. The other was there.
0:06:14 > 0:06:16So the jaw came around.
0:06:16 > 0:06:18The shark expert said when I was surfing, it would
0:06:18 > 0:06:22have come from behind and he reckons the whole nose of the shark
0:06:22 > 0:06:24would have been between my legs.
0:06:24 > 0:06:26I've been back in heaps of times.
0:06:26 > 0:06:29The next day I went in for a lunch-break surf at work.
0:06:29 > 0:06:33I'll definitely have a look around now, a little cautious,
0:06:33 > 0:06:35but I still love it and I've done it my whole life
0:06:35 > 0:06:38and it's not going to stop me. We're in their territory.
0:06:42 > 0:06:46Dee Why Beach has been reopened and the shark attack doesn't appear
0:06:46 > 0:06:49to have put many beachgoers off, although the lifeguards say
0:06:49 > 0:06:53some foreign tourists have probably watched too many shark movies.
0:06:53 > 0:06:56A lot of English backpackers down here.
0:06:56 > 0:06:57They've definitely got their questions.
0:06:57 > 0:07:01Sharks are usually at the top of the list. "Where did you get that from?"
0:07:01 > 0:07:02And straightaway they refer back to Jaws.
0:07:02 > 0:07:06Jaws is a story that's getting told back at home.
0:07:06 > 0:07:09Everyone's getting freaked out by it.
0:07:11 > 0:07:15I don't know whether girls worry about it more than boys.
0:07:15 > 0:07:17I surf a little bit and I always worry about sharks,
0:07:17 > 0:07:21but a lot of the surfing culture over here, they go in anyway.
0:07:21 > 0:07:23Doesn't put you off coming down here.
0:07:23 > 0:07:26It's Australia, you know there are sharks are around.
0:07:26 > 0:07:29If you keep in the back of your mind, you'll be fine.
0:07:31 > 0:07:33And for any nervous swimmers,
0:07:33 > 0:07:36the Life Saver Helicopter shark patrols are reassuring.
0:07:36 > 0:07:40They're great to have up above you, keeping an eye on you.
0:07:40 > 0:07:43The only scary moment is when they stop and hover above you, and that
0:07:43 > 0:07:46generally means they've seen something, so that's a good indicator to get out.
0:07:49 > 0:07:53Shark attacks on humans off the Australian coast are rare,
0:07:53 > 0:07:56and the chances of being killed by one are very slight.
0:07:56 > 0:08:02In 2012, 14 people were injured by sharks in Australia,
0:08:02 > 0:08:04and two people were killed.
0:08:05 > 0:08:08Luke Allan is one of the lucky ones.
0:08:08 > 0:08:10Ten weeks ago, he was attacked
0:08:10 > 0:08:15while he was serving in a remote bay 220 miles north of Sydney.
0:08:15 > 0:08:18I didn't notice him until he was attached to my leg,
0:08:18 > 0:08:20so the initial force felt like
0:08:20 > 0:08:25someone was pressing a hit on me in a rugby game.
0:08:25 > 0:08:28Not a sharp pain or anything, just pressure,
0:08:28 > 0:08:34and he pushed me to the side and latched onto here and thrashed,
0:08:34 > 0:08:40which sort of opened this first wound up and he just kept biting
0:08:40 > 0:08:43as he went down, so he had one sustained bite, which was up here,
0:08:43 > 0:08:47and then a second pretty much surgical incision puncture wound,
0:08:47 > 0:08:51and the third one was a full thickness bite.
0:08:52 > 0:08:56Luke was attacked by a bull shark, which scientists recently discovered
0:08:56 > 0:09:00has the strongest bite of any shark species, including the great white.
0:09:02 > 0:09:04So Luke has had a lucky escape.
0:09:04 > 0:09:08He took this one off clean, and actually skimmed this one down
0:09:08 > 0:09:13so it was on the back of my hand, and before I went into surgery,
0:09:13 > 0:09:16they said, "You'll lose both of them at the knuckle."
0:09:16 > 0:09:21They did such an excellent job and actually completely rebuilt
0:09:21 > 0:09:25my index finger, which by all rights I should have lost both of them.
0:09:25 > 0:09:27It's reaffirmed my affection for them.
0:09:27 > 0:09:30There's no malice in what they do.
0:09:30 > 0:09:32It's not a rational hatred to have,
0:09:32 > 0:09:36and it's certainly not a rational fear to have, so no hard feelings.
0:09:36 > 0:09:37No harm.
0:09:42 > 0:09:46The Australian summer of 2013 has rewritten the history books,
0:09:46 > 0:09:50with temperatures in Sydney topping 40 degrees Celsius.
0:09:51 > 0:09:54But the old and young can't just cool off on the beach.
0:09:54 > 0:09:58And today, British doctor Shalika Shetty has been sent to pick up
0:09:58 > 0:10:00a casualty of the heatwave.
0:10:01 > 0:10:04But she's not going by air.
0:10:04 > 0:10:08We cover New South Wales, so it's a massive area,
0:10:08 > 0:10:10about three times the size of England.
0:10:10 > 0:10:14So we do need the helicopter for some retrievals which are very far out.
0:10:16 > 0:10:18This unit is quite a short distance,
0:10:18 > 0:10:22so it's doable by an ambulance, it's about half an hour.
0:10:22 > 0:10:24Dr Shalika has just left the UK
0:10:24 > 0:10:28and is in the third week of her secondment down under.
0:10:28 > 0:10:29She's been there for four days,
0:10:29 > 0:10:33and she's been progressively deteriorating,
0:10:33 > 0:10:36so I think it's unlikely that she's going to suddenly get better.
0:10:36 > 0:10:39She's on an urgent call to pick up a six-week-old baby girl with
0:10:39 > 0:10:43severe dehydration, a condition not uncommon in this part of the world.
0:10:45 > 0:10:49In Australia, we tend to be a hot climate. We can have hot days.
0:10:49 > 0:10:52Last month, there were days in the 40s here in Sydney.
0:10:53 > 0:10:57Anyone's at risk of dehydration, and in particular a six-week-old baby
0:10:57 > 0:11:02who's got diarrhoea anyway and dehydrated, then the chances
0:11:02 > 0:11:05of them becoming more dehydrated in that sort of environment increase.
0:11:07 > 0:11:10This baby's already been given quite a lot of fluids,
0:11:10 > 0:11:13so you'd normally expect a response, but in this case,
0:11:13 > 0:11:17that hasn't happened, so it's not your usual patient,
0:11:17 > 0:11:19so there could be something else going on.
0:11:19 > 0:11:21The baby's parents brought her here
0:11:21 > 0:11:24to Mount Druitt Hospital in Sydney's suburbs.
0:11:24 > 0:11:25Now it's down to Dr Shalika
0:11:25 > 0:11:29and Nurse Mel to transfer her back to central Sydney for treatment.
0:11:29 > 0:11:33We're just going to go and find our patient and assess them
0:11:33 > 0:11:34and speak to the parents,
0:11:34 > 0:11:37and then make a plan of management before leaving.
0:11:42 > 0:11:46You're very reliant on each other, so it's really important that
0:11:46 > 0:11:48you're aware of your differing skill sets and abilities
0:11:48 > 0:11:51and it tends to work very well.
0:11:51 > 0:11:54Come on! Put some muscle in there, Mel!
0:11:54 > 0:11:56SHE LAUGHS
0:11:56 > 0:12:00Oh, my gosh, she's... What have you done?
0:12:00 > 0:12:01It's not...
0:12:01 > 0:12:05BABY CRIES
0:12:05 > 0:12:08We're watching for any signs of deterioration,
0:12:08 > 0:12:12so we're watching constantly her heart rate and her respiratory rate,
0:12:12 > 0:12:15and we're just checking the blood pressure and profusion is good,
0:12:15 > 0:12:18and her heart is circulating the blood properly.
0:12:24 > 0:12:28The reason that we're moving her is we've just repeated
0:12:28 > 0:12:31a couple of blood tests, and what they're showing is that she
0:12:31 > 0:12:33has a quite significant metabolic acidosis,
0:12:33 > 0:12:37despite being given a lot of fluid therapy, and it's not clear as to
0:12:37 > 0:12:41why this is, so were querying an underlying condition that's causing
0:12:41 > 0:12:46this, and it's not clear what, and that will need further investigation.
0:12:57 > 0:12:58The concern happened overnight.
0:12:58 > 0:13:00She seems to have become more dehydrated,
0:13:00 > 0:13:03and the thing is that she didn't have a fluid balance being monitored.
0:13:03 > 0:13:05She became very dry overnight,
0:13:05 > 0:13:08and in the morning she was quite lethargic, dehydrated,
0:13:08 > 0:13:09sunken fontanelle, sunken eyes.
0:13:09 > 0:13:11We've just handed her over to the team here
0:13:11 > 0:13:15and what we're going to do is have a bit more of a metabolic workup,
0:13:15 > 0:13:19so the metabolic team here are going to come and review her and hopefully
0:13:19 > 0:13:23have a plan as to what's going on and to investigate it further.
0:13:25 > 0:13:27It's interesting,
0:13:27 > 0:13:30because it's quite different from a lot of the other jobs.
0:13:30 > 0:13:34In this job, every single mission we go on is different, I think
0:13:34 > 0:13:37that's one of the great things. There's a lot of variety.
0:13:37 > 0:13:42But the fact that we don't actually know what's going on
0:13:42 > 0:13:47is quite interesting, and hopefully we'll find out very soon.
0:13:52 > 0:13:55But the mystery continues, and even after a string of tests,
0:13:55 > 0:13:59the experts are still struggling to diagnose exactly what's wrong.
0:13:59 > 0:14:03I've got a couple of ideas about what could be.
0:14:03 > 0:14:06Infection and allergy would probably be top of the list.
0:14:06 > 0:14:10We may need to do more invasive tests, like endoscopy
0:14:10 > 0:14:14and small bowel biopsy to give us that diagnosis.
0:14:14 > 0:14:17But Dr Storman is still really impressed by the work Dr Shalika
0:14:17 > 0:14:21and the rest of the British medics are doing here in Sydney.
0:14:21 > 0:14:25They come well trained. They're usually happy to work hard.
0:14:26 > 0:14:29They're here to have a good time. Work hard, play hard.
0:14:29 > 0:14:31Yeah, we do have a lot of British doctors who come here.
0:14:31 > 0:14:35A lot of them come and settle here for various reasons,
0:14:35 > 0:14:38- steal our women... - HE LAUGHS
0:14:38 > 0:14:41It's a very multicultural society
0:14:41 > 0:14:44here in Australia, particularly in Sydney.
0:14:44 > 0:14:46Eventually, doctors discover
0:14:46 > 0:14:49that the baby has a problem with her liver.
0:14:49 > 0:14:52She has to return to hospital for regular treatment.
0:14:56 > 0:14:58At the ambulance service helicopter base in Sydney,
0:14:58 > 0:15:01they've had a call about a 19-year-old who's been
0:15:01 > 0:15:05thrown off his horse and is now unconscious.
0:15:05 > 0:15:09RADIO: Looks like there is plenty of good landing space at the site.
0:15:09 > 0:15:13The doctor onboard is trauma specialist, Shane Trevithick.
0:15:13 > 0:15:16For the last ten years, Dr Shane, has been recruiting British doctors
0:15:16 > 0:15:19to work on rescue helicopters in New South Wales.
0:15:21 > 0:15:25In Australia, amongst intensive care, anaesthesia and emergency medicine every year,
0:15:25 > 0:15:34there aren't quite enough trainees who have a passion for working on pre-hospital rescue and helicopters.
0:15:34 > 0:15:36So, we simply have to look further afield to get
0:15:36 > 0:15:40the 20 to 30 doctors a year we need to fill the rosters.
0:15:40 > 0:15:48We use people from England, Ireland, mainly because they have pretty much the same training our doctors do.
0:15:48 > 0:15:51And they can fit into our system fairly easily.
0:15:51 > 0:15:55RADIO: We're at the scene, 281 Maroubra Road.
0:15:55 > 0:15:58Located at the back of the residence at this stage.
0:15:58 > 0:16:04Er...we're more than likely going to have to walk in from here due to limited access.
0:16:04 > 0:16:06We have such enormous distances,
0:16:06 > 0:16:11we can't have a high-quality hospital every hour, even every two hours.
0:16:11 > 0:16:15Sometimes you've got to travel more than four or five hours to get to a hospital.
0:16:15 > 0:16:19In that case, we do a lot of aeromedical retrieval for those patients.
0:16:19 > 0:16:22And that's where there's a huge difference.
0:16:22 > 0:16:25RADIO: We're doing a recci as we speak.
0:16:25 > 0:16:28It takes just 25 minutes to get to the accident.
0:16:28 > 0:16:31By road it would have taken an hour and a half.
0:16:31 > 0:16:36In cases of head injuries like this, time is critical.
0:16:36 > 0:16:38- G'day.- G'day, Doc. How are you goin'?
0:16:38 > 0:16:41The patient over here?
0:16:41 > 0:16:43My son has had a fall from a horse.
0:16:43 > 0:16:47And he's unconscious, or he is in and out of consciousness.
0:16:47 > 0:16:49We're going to intubate in the helicopter, yeah.
0:16:51 > 0:16:53The 19-year-old patient, Aaron Erwin,
0:16:53 > 0:16:56was riding out on land owned by his family in Wingello,
0:16:56 > 0:17:00a tiny village halfway between Sydney and Canberra.
0:17:00 > 0:17:03Yeah, yeah, we're gonna get him straight out now.
0:17:05 > 0:17:08Aaron was with his father when he came off his horse.
0:17:08 > 0:17:11His mother, who is a nurse, rang for the ambulance.
0:17:11 > 0:17:13Nice and easy.
0:17:16 > 0:17:19- All right, everybody ready? - One, two, three...
0:17:20 > 0:17:23The bridge is a mobile intensive care unit,
0:17:23 > 0:17:26used in all the rescue helicopters in New South Wales.
0:17:26 > 0:17:28AARON GROANS
0:17:28 > 0:17:29OK.
0:17:29 > 0:17:31GROANING
0:17:31 > 0:17:32OK, all done.
0:17:32 > 0:17:35It's a lightweight tray which sits over the stretcher
0:17:35 > 0:17:40and holds the monitoring equipment, a ventilator and the oxygen and infusion pumps.
0:17:43 > 0:17:47Dr Shane is about to perform one of the most risky procedures
0:17:47 > 0:17:50that can be done outside a hospital environment.
0:17:51 > 0:17:54He's going to give Aaron a powerful anaesthetic,
0:17:54 > 0:17:58and then Huey, the paramedic will push a tube down his windpipe
0:17:58 > 0:18:00so he can take over Aaron's breathing.
0:18:00 > 0:18:05Because of his degree of agitation, he'll need a CT when he gets to hospital,
0:18:05 > 0:18:08and the safest way to do that is to intubate him.
0:18:08 > 0:18:11Yeah, the best way to do that is for me to intubate him here.
0:18:11 > 0:18:14Or ask Huey and I will intubate him,
0:18:14 > 0:18:16so, I'm pre-oxygenating him at the moment.
0:18:16 > 0:18:21Even the simplest thing is made more difficult by doing it
0:18:21 > 0:18:23out in the open or in the helicopter.
0:18:23 > 0:18:29We like to take control of our environment, rather than letting the environment take control of us.
0:18:29 > 0:18:33The sun is this way. So, you are going to have to...
0:18:33 > 0:18:34Go from this way.
0:18:36 > 0:18:39- Patient position optimised, confirmed.- Yeah.
0:18:39 > 0:18:44OK, sufficient O2, we've got the aircraft and we've got about two sources.
0:18:44 > 0:18:47- Pre-oxygenation done?- Complete.
0:18:47 > 0:18:49- Suction tested?- Yeah.
0:18:49 > 0:18:53Even though Aaron needs to get to hospital as soon as possible,
0:18:53 > 0:18:58it's essential that everything is properly checked before Dr Shane anaesthetises him.
0:18:59 > 0:19:03A simple mistake now could lead to very serious problems
0:19:03 > 0:19:05when they start this risky medical procedure.
0:19:10 > 0:19:14Australia's economy is in relatively good shape compared with
0:19:14 > 0:19:17the country the British doctors are arriving from.
0:19:17 > 0:19:22Unemployment is low, and growth was 9% over the last three years.
0:19:22 > 0:19:25House prices in some places have doubled in a decade,
0:19:25 > 0:19:28which means the construction business is booming.
0:19:32 > 0:19:36If you have a serious accident in Australia, it's far more
0:19:36 > 0:19:40likely the ambulance that comes to you will be bringing a doctor.
0:19:42 > 0:19:47Consultant, Sarah Coombes, left Yorkshire to become a flying doctor in New South Wales.
0:19:47 > 0:19:51But today, she's left the helicopter behind.
0:19:51 > 0:19:53We respond to a whole range of things,
0:19:53 > 0:19:57so we've got the pre-hospital trauma and that is a lot of car accidents,
0:19:57 > 0:19:59as you would expect, the same as back home in the UK.
0:19:59 > 0:20:04We'll also go to cliff falls, some falls from heights.
0:20:04 > 0:20:07The work here is something I cannot do at home now.
0:20:07 > 0:20:11Emergency medicine back home has changed a lot since I've left.
0:20:12 > 0:20:18And you don't get to do lots of the hands on critical care you get to do out here in Australia.
0:20:18 > 0:20:21She's heading to this building site where ground worker,
0:20:21 > 0:20:25Larry McMillan, has had a serious accident with a pneumatic hammer.
0:20:25 > 0:20:28I'm just gonna send someone to have a look for the instrument
0:20:28 > 0:20:31that's actually caused the injury to this gentleman.
0:20:31 > 0:20:33It's a jackhammer by the sounds of it.
0:20:33 > 0:20:37He was changing the bit and I don't know how he's managed to do it.
0:20:38 > 0:20:42I saw a bit of commotion and come across and seen someone hurt and tried to help them.
0:20:42 > 0:20:45His orbit looks OK, his eye looks intact.
0:20:45 > 0:20:49He's complaining of a 7/10 pain and all his obs are quite stable.
0:20:49 > 0:20:53The gentleman was sort of walking back and forth, holding his face.
0:20:53 > 0:20:55As I came out, he fell to the ground.
0:20:55 > 0:20:58So, I grabbed a few towels because I could see blood on his hands.
0:20:58 > 0:20:59I tried to help.
0:20:59 > 0:21:04I'll just have a look and make sure the eye movements are good and sensation is good,
0:21:04 > 0:21:07and see if he's got anything other than a simple zygoma.
0:21:07 > 0:21:10We're also just about to put a cervical collar on too.
0:21:10 > 0:21:14Larry, I'm Sarah, I'm one of the helicopter doctors. How are you?
0:21:14 > 0:21:15Not so good.
0:21:15 > 0:21:22OK, any pain down here? No pain at all? OK.
0:21:22 > 0:21:26You feel me touching here? Here? Beautiful, OK.
0:21:26 > 0:21:30I want you to gently turn your head to look over your left for me...
0:21:30 > 0:21:33Lift your head up and put your chin on your chest.
0:21:33 > 0:21:35No pain in your neck when you do that?
0:21:35 > 0:21:37OK, so his cervical spine is cleared.
0:21:37 > 0:21:41It looks like he was changing the actual bits out of the pneumatic jackhammer,
0:21:41 > 0:21:44so he's gone to put the second piece in over here.
0:21:44 > 0:21:47There's actually still compressed air in the jackhammer so when
0:21:47 > 0:21:51he's loaded it, it's actually sprung back out and hit him in the face.
0:21:51 > 0:21:55So it's quite a decent implement that's hit him with a fair bit of pneumatic force.
0:21:55 > 0:21:59Just open your mouth for me, darling.
0:21:59 > 0:22:03I'm going to slide my fingers in your mouth, and just to feel round that upper jaw.
0:22:05 > 0:22:10Tender in there, yeah? I'm just going to grab your teeth and give a wiggle.
0:22:10 > 0:22:14The initial report on this was that he had a reduced level of consciousness,
0:22:14 > 0:22:16so a risk of a brain injury.
0:22:16 > 0:22:20And bringing a doctor to the scene you can potentially secure somebody's airway,
0:22:20 > 0:22:24manage their ventilation to give them the best chance of surviving a brain injury.
0:22:24 > 0:22:29And then we would take them to a neurosurgical centre so we would probably take them into Sydney.
0:22:29 > 0:22:33But it's clear that it's not needed this time, Larry's been extremely fortunate.
0:22:33 > 0:22:36He's not looking too bad, he's been very lucky.
0:22:36 > 0:22:39He's had a fully charged pneumatic jackhammer hit him in the face.
0:22:39 > 0:22:43Wasn't knocked out by it, but he's got a nasty laceration over his cheekbone.
0:22:43 > 0:22:46Probably got a broken cheekbone, maybe broken his upper jaw here.
0:22:46 > 0:22:49But it all looks in place, all his nerves are working properly.
0:22:49 > 0:22:55So, a bit of pain relief and he can go to the local hospital and they should be able to manage it.
0:22:56 > 0:22:59So Larry, heads here to Wollongong hospital,
0:22:59 > 0:23:04but once inside, they discover just how serious is accident was.
0:23:04 > 0:23:08They found the cheekbone was broken and the eye-socket,
0:23:08 > 0:23:11and damage to the side of the nose.
0:23:11 > 0:23:17The jackhammer went through there, put a hole through my cheekbone.
0:23:17 > 0:23:19Fractured the bottom of my eye-socket
0:23:19 > 0:23:22and to fix it they put two plates in.
0:23:22 > 0:23:25I don't think we're having fish tonight.
0:23:25 > 0:23:28This is a father and son team, who also work together.
0:23:28 > 0:23:31Kane was working as Larry's apprentice at the time
0:23:31 > 0:23:34and was the first one who came rushing to help.
0:23:34 > 0:23:36He was kneeling over to change over the jackhammer
0:23:36 > 0:23:41and basically it went off and hit him in the face.
0:23:41 > 0:23:45He got up and had his hands on his face, so I couldn't really see exactly what happened.
0:23:45 > 0:23:48I didn't really feel it at first, but I thought it hit me
0:23:48 > 0:23:52in the top of the lip and I thought I'd lost my teeth.
0:23:52 > 0:23:55I thought it got him in the eye, so I was expecting to see
0:23:55 > 0:23:57the jackhammer piece coming out of his head...
0:23:57 > 0:23:59..but luckily not.
0:23:59 > 0:24:01Then all of the sudden blood started pouring out of here
0:24:01 > 0:24:03and I thought, "No, it's got me."
0:24:03 > 0:24:08Any pain down here? No pain at all, OK.
0:24:08 > 0:24:13I remember her being there and she basically went over me and checked my wound.
0:24:15 > 0:24:17All I remember is her saying, no,
0:24:17 > 0:24:20he doesn't have to go by helicopter, he can go by road.
0:24:20 > 0:24:24She was really nice. I felt at ease, I felt comfortable.
0:24:24 > 0:24:27Considering the pain I was in.
0:24:27 > 0:24:32Fortunately it caught him just under his cheekbone which stopped the impact.
0:24:32 > 0:24:35If it had been slightly higher it would have gone straight through his eye.
0:24:35 > 0:24:41If it had been slightly lower down it would have gone up through his mouth and through into his brain.
0:24:41 > 0:24:43So he was exceptionally lucky.
0:24:43 > 0:24:46I'm grateful for the outcome for the accident I had.
0:24:47 > 0:24:50I wish I never had the accident, but I did.
0:24:50 > 0:24:52And, the outcome is pretty good.
0:24:52 > 0:24:56I really could've lost my eye and there would be no more fishing.
0:24:56 > 0:24:58It would be hard fishing with one eye.
0:24:58 > 0:25:00I wouldn't be able to ride my motorcycle.
0:25:00 > 0:25:03But I'm pretty happy with how it came out.
0:25:03 > 0:25:06You have to be grateful for that.
0:25:11 > 0:25:14Back in a paddock near the town of Wingello,
0:25:14 > 0:25:17Dr Shane Trevithick is anaesthetising teenage horseman,
0:25:17 > 0:25:21Aaron Erwin, badly injured in a riding accident.
0:25:21 > 0:25:23Good view?
0:25:23 > 0:25:26With a haemorrhage into the brain, it can cause a lot of swelling.
0:25:26 > 0:25:29And with the skull, that's a closed box, effectively,
0:25:29 > 0:25:32with all that swelling, there's no way the pressure to
0:25:32 > 0:25:35go except to force the brain out of the skull, which is fatal.
0:25:35 > 0:25:37Right, let's get going.
0:25:37 > 0:25:41Given the proximity to the nearest hospital,
0:25:41 > 0:25:43this gentleman is quite a distance.
0:25:43 > 0:25:49The most appropriate transport option for this patient, he's being loaded in
0:25:49 > 0:25:53the helicopter now and they are going to be ready to take off very shortly.
0:25:54 > 0:25:58Dr Shane fears Aaron may also have a collapsed lung, but thanks
0:25:58 > 0:26:02to the chopper's ultrasound machine, he can rule that out immediately.
0:26:02 > 0:26:04No, he's got no pneumothorax.
0:26:06 > 0:26:09Aaron's condition is now critical.
0:26:09 > 0:26:12Dr Shane and paramedic, Huey, are in full control of his breathing.
0:26:13 > 0:26:17Have you got that other bag of fluid, mate?
0:26:17 > 0:26:19< It's already up.
0:26:19 > 0:26:22Most people who love horses forget they are unbelievably
0:26:22 > 0:26:24dangerous to the human being.
0:26:24 > 0:26:28They seem to be just the right height that when you fall off them, you're either
0:26:28 > 0:26:32critically injured or you bounce off the ground, have a bruise and get on with life.
0:26:32 > 0:26:34There's no in between with a horse.
0:26:34 > 0:26:38It takes just 20 minutes to get to Aaron into Sydney.
0:26:38 > 0:26:40Happy when you are, mate.
0:26:40 > 0:26:42His life hangs in the balance,
0:26:42 > 0:26:46but Dr Shane can now hand over to a team of surgeons.
0:26:46 > 0:26:49The horse has fallen over sideways, he was thrown off the horse.
0:26:49 > 0:26:51He was wearing a helmet.
0:26:51 > 0:26:55And, he did, once or twice make some moaning sounds...
0:26:56 > 0:26:59The following days are an anxious time for Aaron's family,
0:26:59 > 0:27:02as they wait for news from the hospital.
0:27:02 > 0:27:06Despite still being a teenager, he's a very experienced horseman
0:27:06 > 0:27:09and the accident is a terrible shock.
0:27:09 > 0:27:12It's probably every parent's worst nightmare, I think.
0:27:12 > 0:27:16It's really hard to watch someone you obviously love
0:27:16 > 0:27:20and care about so much, be in that kind of situation.
0:27:22 > 0:27:26Aaron is kept in an induced coma for two days as fluid
0:27:26 > 0:27:29is drained from his skull, easing the pressure on his brain.
0:27:29 > 0:27:32Then doctors wake him up.
0:27:32 > 0:27:35On extubation, he did really well, but he had trouble walking
0:27:35 > 0:27:38and some short-term memory issues.
0:27:38 > 0:27:41So, he was sent to the brain injury rehab unit,
0:27:41 > 0:27:44at Liverpool hospital for a few weeks.
0:27:44 > 0:27:50And now, we have two just work on his balance and his processing
0:27:50 > 0:27:53of information that goes in, it's a little slow,
0:27:53 > 0:27:55which is pretty typical of that sort of brain injury.
0:27:55 > 0:27:59But, really, a month later, he's doing extremely well.
0:27:59 > 0:28:03And that's because he got early intervention.
0:28:03 > 0:28:06Aaron is one of Australia's youngest professional riders.
0:28:06 > 0:28:11He recently gave up his job to concentrate on rehabilitating problem horses.
0:28:11 > 0:28:14I didn't want to be a mechanic for the rest of my life,
0:28:14 > 0:28:16and I didn't want to do something I didn't enjoy.
0:28:16 > 0:28:20This is what I enjoy, so I thought, why not.
0:28:20 > 0:28:25Aaron has been riding since he was five, and this isn't going to stop him.
0:28:25 > 0:28:28I would love to compete in the Olympics when I'm older.
0:28:28 > 0:28:30It's a long, hard journey to get there.
0:28:30 > 0:28:33Accidents happen, yes.
0:28:34 > 0:28:37You know, it's not going to stop me.
0:28:41 > 0:28:43Subtitles by Red Bee Media