Episode 7 Helicopter Heroes

DIDGERIDOO SOUNDS

-RADIO:

-CareFlight, 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 her coming round.

..they're 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.

-VOICES ON RADIO:

-'Life Saver 24.'

'They say they've got the bends from coming up too quickly.'

From shark attacks on surfing beaches,

-to exploding barbecues in the Sydney suburbs...

-Went round you?

..these are the Brits who can make the difference

between life and death Down Under.

-Is that all right?

-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.

Been 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, a teenager who's been thrown off his Jet Ski

needs the flying medics.

Fly us there next to the beach, visual with the ambos as well, they're on the beach.

A diver has a suspected case of the bends.

He's either suffering decompression illness

or something else is going on.

And a four-year-old is crushed by a cupboard.

Most of the team here have children of their own

so there's a little bit of added pressure.

Aussies love messing around on the water.

The country's home to 800,000 pleasure boats.

From ocean-going yachts to gin palaces, dinghies to speedboats.

One in ten Aussies sail for fun and other water sports are booming, too.

The Hawkesbury River is not as famous as Sydney's beaches

but locals know it's one of the best places in New South Wales

to get out on a Jet Ski.

And that makes plenty of work for the CareFlight team.

CareFlight is called

if a patient is unconscious or is suspected of having a head injury.

All we have at the minute is Windsor, we'll just head off in that direction,

I'll get more details en route.

Today, they're on their way to a teenager who's hit his head

after being thrown off his Jet Ski into the water.

It's about a kilometre to the north of Windsor

on the far side of the river.

Yeah, copy that, mate. Cheers.

Before he moved to Australia, John Legge from Liverpool

-served in Afghanistan with the RAF.

-The important thing for us is time.

We need to get there as fast as we can.

If we don't do that, then they may as well send an ambulance.

The accident has happened at an activity centre near Windsor

which is 30 miles north-west of Sydney.

The boy fell off the boat and we just saw them waving us down.

We came past and he was just in the water unconscious,

pretty white-looking.

RADIO: Yeah, this is Wilberforce Road,

which is the address we were given.

It's John's job to work out where the pilot should head for,

but once the chopper gets close, the whole team is on look-out.

Can see some Jet Skis down there.

You'll see the go-kart track which is right next to the butterfly farm.

Visual with the ambulance in the three o'clock.

Keep her coming round, keep her coming round.

Right there, next to the beach. Visual with the ambos as well,

-they're on the beach.

-We could land in that overlay on the front.

Yeah, that's probably better, isn't it?

Yeah, straight in for that one, there.

100 around. 40 below the building.

INAUDIBLE INSTRUCTIONS

Two below to ground, one left main coming on,

right main coming off, six inches on the nose. Nose is down.

Down, secure and firm.

CareFlight has arrived within 12 minutes of getting the call.

How are you?

This is Zack on the back of the Jet Ski.

-Yeah.

-Observing, facing backwards.

-Yeah.

Fell off, the guy on the tube hit him in the head.

-Complaining of neck pain.

-Ah, my neck!

ZACK GROANS IN PAIN

14-year-old Zack Boyd is a Jet Ski novice.

Yeah, yep. OK.

We just need to get rid of that lifejacket.

Why don't we pick him up on it?

'I was on the phone straight away to triple-O.'

It was his first time on the Jet Ski so he was on the back

observing and he's fell off and the tube's run him over.

Beautiful. OK, we'll take the lifejacket off. Hang in there.

Can we have another couple of people who...

Can you come and give us a hand?

I'll hold onto his head.

Can you put your hand over the other side, sir?

-Yep. Got it?

-Want us to help?

-Now walk towards me.

-Follow me, follow me.

-He was pretty white and he wasn't moving.

His eyes were rolling back in his head and he was shaking heaps.

Ready to lower? Lower.

What we might do,

we might put the collar on and then roll him and take the lifejacket off

then we might cover him and get him up onto the dry stuff

-and we'll go from there.

-OK.

The CareFlight team is concerned that Zack might have a serious

head injury so they need to get him to hospital fast.

Hi, Peter. It's John from CareFlight Four.

We just picked up a patient and we're going to bring him to your HLS,

he'll be the next landing site

and we'll probably be there in about 20 minutes, I'd say.

I'm a bit worried about his neck and I'm also worried that he hasn't...

can't remember anything today,

which can be a sign of a head injury.

So he definitely needs observation.

There are some conditions where you look all right

and then go off again and certainly

that's why we've got a whole heap of stuff ready in the aircraft

in case he does go off in flight.

Stick the tail around to the right,

we'll back into this pavilion over here and take off to the north.

The CareFlight helicopter may be small and a bit cramped

but it's very fast. It can travel at 190mph.

One of the downsides of transporting patients by air

is it can make them sick...

He's had a massive vomit

-but probably best keep going at this stage.

-OK.

..especially when they've swallowed a few gallons

of the Hawkesbury River, like Zack has.

-We'll just get in as quick as we can.

-Sure.

So everyone's relieved when they finally get to hospital,

particularly, paramedic Ben Southers.

There's a fair bit of vomit gone through the back cabin.

Zack has a CT scan which confirms

that he hasn't suffered a serious head injury.

He's allowed to go home the same day.

Every year, hundreds of British doctors apply for visas

to work in Australia.

The ones who join the air ambulance in Sydney will have spent an average

of ten years training in the most advanced aspects of modern medicine.

But when they arrive here,

it's back to square one in the basics of flying.

Harness checked, secure. J-knife fitted and clear of D-ring,

so check my harness, all fine, and my J-knife is clear.

Dr Hilary Eason is undergoing a refresher course in winching,

perhaps the most dangerous part of a flying doctor's job.

Going for a thumbs-up? Got a thumbs-up.

We don't get operational winches or hover-entry exits very often

so it's really important to be familiar with the procedure.

I'm the rescuer, I don't have any equipment that needs to be attached,

-that's the patient so they're complete.

-Yep.

'When we get to do it, it's quite a stressful situation anyway,

'not least if you're not familiar with the equipment.'

Dr Hilary and fellow Brit David Anderson

must be able to descend from the chopper

on a wire thinner than her little finger

in all weathers, day or night.

And today, she's doing it at sea.

RADIO: 'Rescue 26 is now in flight.'

INAUDIBLE COCKPIT MESSAGES

These waters are a training ground for the ambulance service

of New South Wales Air Ambulance crews.

But beneath the surface, they're a playground for divers.

Diving is big business around Sydney.

The water's clear, rarely cooler than 22 degrees Celsius

and teeming with marine life.

And up the coast north of Sydney,

the Australians have sunk a warship to explore.

HMAS Adelaide is now a man-made reef

but wreck diving is a risky sport and today Dr Hilary is

called off winch training to rescue someone who may have the bends.

-RADIO:

-Rescue 24, we've been passed by Aeromedical Operations

to go to Erina. Can you give us some details on this case, please?

We're out flying and we have very limited details.

However, this diver is already on dry land.

He didn't start feeling unwell

until he was driving back to his home in Sydney.

And now Rescue 24 is heading for a cricket pitch in the suburbs.

The bends is a potentially fatal condition.

Bubbles of nitrogen build up in the body causing agonising pain

in the joints. It can lead to permanent disability.

So, this is a middle-aged gentleman who's surfaced from a wreck dive,

his second dive of the day, and he's got possibly joint pain

and epigastric pain, so he's either suffering decompression illness

or something else is going on, such as he's got a cardiac condition

or...um, well, we'll see!

-Hey. Hi, guys.

-How are you going, guys? This is Hilary.

-Hello.

53-year-old Mark Batterns is a firefighter who's been

sports diving for 30 years.

He's highly qualified and very fit but the bends can affect anyone.

-Mark?

-Hard to breath.

-OK.

And just general sickness.

-OK, that pain in your abdomen, is it here?

-Yeah.

-OK.

Just describe it to me.

Just like a dull ache at the moment.

A dull ache, OK. Have you had anything like that before?

-No.

-Have you got any heart problems?

-No.

-Never had chest pain for any reason?

-No, never.

That sensation in your chest, does it goes anywhere else, into your arm?

-No.

-Nothing like that?

-It's more like a nauseous feeling.

-Yeah, OK.

He may need a session in a hyperbaric chamber

which recreates the pressure divers experience at depth.

We'll put it back on.

There's two things that could be going on.

Yes, you've had two dives today so there's a pretty high chance

that it could be something related to the bends or decompression sickness.

The other thing is any other sensation that feels a bit strange

in your chest could well be your heart

so we need to treat you for both, really.

Mark's symptoms are concerning Dr Hilary.

We've treated him in case he has got cardiac chest pain

and he's on high-flow oxygen.

We'll take him as soon as possible as low as possible in the aircraft

to Prince of Wales where they've got a great emergency department

and also a hyperbaric chamber, if he does need recompressing.

Locked in, just roll him forward.

At Sydney's Prince of Wales Hospital,

the hyperbaric chamber is being prepared for Mark.

By returning him to the pressure he experienced during his dive,

his body will be able to dissolve

any nitrogen bubbles in his bloodstream.

Most patients who have any sort of symptoms soon after diving

get referred to us.

The problem we have to sort out is, is it a diving-related problem or

a normal medical problem? That's quite difficult to work out.

For Dr Hilary, Rescue 24 will have her patient

in the hyperbaric unit within ten minutes.

For the pilot, this will be a challenging flight.

Altitude can worsen the symptoms of the bends

so he'll be flying as low as possible.

RADIO: ..1,400 feet, another one just to the north, 2,700 feet...

Luckily, Sydney is one of the easiest cities

in the world for helicopter pilots to fly through.

If they follow the river, they don't even need clearance

from air traffic control.

At the hospital, Mark goes through a battery of tests

but the results are confusing.

There's no amazing diagnostic test to tell you

if someone has got decompression illness or not.

"The bends," so-called. There's no amazing test,

it's more to do with the history and the examination.

And so it takes a fair bit of nous try and sort that out.

Doctors decide against putting Mark in the chamber

and he's later allowed home after a period of observation,

unaware that he's Dr Hilary's last patient

after a year as an Australian flying doctor.

We're taking the skills that we've learned over here

and bringing them back to the UK.

Our training costs in excess of 30,000 Australian dollars

and that's access to training that I would never have received in the UK.

When night falls, Aussies have a reputation for liking a drink

but that has its downside.

One in four fatal crashes involves drivers

who are above the legal limit.

How are you going? Can I see your license, please?

You've been stopped for random testing.

That's why police random breath tests stations - or RBTs -

are a common sight in Sydney,

especially on Friday and Saturday nights.

We have a major operation, drug and alcohol testing operation,

on the Sydney Harbour Bridge here.

He's blown over six times the legal limit, it's only 8:30 at night.

We've got him off the road, thank God.

We've been doing it for over 30 years but I know we have saved

tens of thousands of lives by doing RBT. That's why we're here.

The Government claims that over 7,000 fewer people have

died on the roads in New South Wales

since random breath testing was introduced.

But it's hard for some Australians to shake off their drinking culture.

You can wear my helmet, mate, if you want.

I'll give him a call, we'll get down there, get a report.

It's just a trapped male?

And today, Dr Sarah Coombes from Yorkshire

and paramedic Graham Goodman are dealing with the consequences.

They're fighting their way through traffic on the Princes Highway,

75 miles south of Sydney.

They're on their way to a serious road accident

where the driver may have been drinking.

He was speeding and he hit the rail

and bounced across the other side of the road.

Back home, doctors rarely travel to accidents with ambulance crews.

In the UK, the BASICS doctors are volunteer doctors.

Here, we're very much part of the ambulance service and we're

an extra bit of the armamentarium that the ambulance service have.

-Hi, I'm Sarah.

-G'day, Sarah.

He was drag racing with four other cars.

-Witnessed high speed. First impact just up here.

-Yeah.

-They've gone across the road and it hit the barrier.

-Yeah.

-He was a little bit confused when I turned up.

-Yeah.

He's now able to say his name, where he was going.

-He was on his way home from work, so forth.

-Yeah.

He's definitely dislocated, possibly fractured his right shoulder.

-OK.

-How much have you had to drink?

-Three beers.

-Three beers?

On any medicines for anything? You've not taken any drugs today? OK.

I'm going to have a little feel of your chest and your tummy.

If I do anything that causes you pain, will you tell me?

-Of course, yeah.

-OK.

HE GROANS

Dr Sarah and the paramedics suspect that the man has had

more to drink than a few beers, and that he also might be high on drugs.

I think what we should do is take you to St George Hospital in Sydney

because you've had a pretty high impact there.

Given it's your chest, it's more sensible to take you

in the helicopter to a major trauma centre.

-OK?

-Thanks, Andy. Just giving you an update, mate.

We are loading this patient into 163 at this point of time,

we're going to ferry down to Kiama Harbour.

I've booked an aircraft, helicopter will be here in about ten minutes

and we'll transport to St George, thanks.

The rescue helicopter will fly out from base

and land as close to the scene of the accident as possible.

At the moment, he's had a pretty significant high-speed impact,

lots of pain in his right upper chest and right shoulder

and in his right upper abdomen so I'm worried that he's damaged

ribs and lung and possibly his liver as well.

We'll pop him in the back of the ambulance

and drive him to the nearest landing site for the helicopter

and then we'll fly him to St George, major trauma centre.

-Coming with us or going with him?

-I'll go with him.

-I'll take the board.

-OK, ta.

Patients who have alcohol or drugs in their system

can become aggressive.

Dr Sarah needs to be certain that this man is calm enough

to travel safely in the aircraft.

Maybe once we're in the helicopter,

we'll get you sorted out, it won't be long.

MUFFLED GROANS

I'm worried about your spine cos you've had a significant impact.

-OK.

-And you've got a lot of pain in the shoulder that may be

distracting you from pain in your spine.

HE GROANS I'm just doing an ultrasound, called a FAST scan,

a focused abdominal scan in trauma to look for any free blood

that may be a sign that he's damaged some of his abdominal organs.

-RADIO:

-New entry, go ahead.

-Thank you.

Yeah, Rescue 26 is now in flight to St George, ETA at 1845, 1845.

Repeat that, St George's Hospital, ETA 1845,

thanks very much for your help.

Whether they're working in the UK or Australia,

doctors like Sarah have to put their personal feelings to one side

when they're treating a patient.

This can be hard to do

when patients put their own lives at risk as well as the lives of others.

'It's everybody else on the road that they're likely to impact.

'It's incredibly frustrating. Not just the road accidents we go to.

'a lot of the work we go to is the result of people

'not being properly prepared for the activities they're doing

'or doing stupid things'

and you just have to bite your tongue and get on with it

and not have a go at them

because obviously we're not here to be judgemental.

We're here to treat them and even though inside you're thinking,

"You idiot", you can't really say it.

The drink-driver in this case escaped a serious head injury.

He was treated for a broken shoulder and fractured ribs.

The scenery may be better but the Sydney rush-hour is

the same as any other big city's - long, slow and frustrating.

Thousands bypass the jams by catching a ferry to the office

but many commuters prefer to go by bike.

This morning, Dr James Milligan has been scrambled to the

kind of emergency he was used to

back on the chillier streets of Leeds.

On the main road into town from the suburbs, a biker has come off.

The jams are already building and the crew of Rescue 21

must find somewhere safe to land in the woodland suburbs.

Hey, guys.

-G'day.

-Gentlemen.

-Nice to meet you.

-Doctor.

-Oh, we met before.

-What's your name?

-James.

-James, how are you, James?

-Don't worry about it.

-Andy Thompson, how are you?

-Good. Hi, buddy.

-This is Paul.

-Paul Petkowski is 24 and a keen motorcyclist.

He had all the right gear including Kevlar body armour

-which is probably why he's still alive.

-He was on the way to work.

-Felt unwell, turned around to go back home.

-OK.

He was travelling around that speed

-and sideswiped by a motor vehicle.

-OK.

And complains of significant pain around his pelvis and thigh,

-right thigh area.

-Yeah.

-Significant damage to his helmet, just here.

Yeah, I saw that.

-Where he's actually come down.

-Took a bit of a crack, didn't he?

-Yep.

This is the Princes Highway, a major urban route

and the accident's delaying thousands of commuters.

But Paul must come first.

-Hey, Paul.

-Hi.

-My name's James, one of the doctors. How are you doing?

-MUFFLED:

-I'm all right.

I've just heard all about you

but tell me which bit's hurting you the most at the minute?

-My elbow.

-Your elbow.

He does have what looks like a puncture wound to his elbow.

-It more looks like a burn.

-Two lines, or is that just a dressing?

-Only the one line.

-Just the one line.

-Yep.

-Big breath.

Dr James knows the accident caused Paul's injuries

but he's curious about what made him feel unwell in the first place.

-And out.

-Pulse rate's 104.

One by one, he quietly rules out any serious underlying health problems.

Do you remember the ambulance turning up?

-I didn't see anyone else.

-OK.

-I just said, "Is this a dream?"

-All right. Do you know where you are now?

-In the ambulance.

-In the ambulance, yes.

We'll get you to St George, more precautionary than anything else

just to check everything's all right. You've come off at a fair whack.

-OK.

-We'll get everything sorted from there.

Dr James is satisfied his patient's injuries are painful

but not critical. It's safe for him to travel by road.

I think we're going to road him.

It's 15 minutes to St George's, I think we should just get moving.

Luckily, he didn't go under a car or a truck or something else.

So considering he was going fast and hit the road hard, he's very lucky

he's only got lower limb fractures and he'll do pretty well.

He's on his way to St George with our doctor looking after him.

We're going to get out of here and open the highway again.

Biker Paul won't be joining the rush-hour again

until his injuries are healed but he's had a lucky escape.

In the heat of an Australian summer, too few bikers wear the right gear

and many need skin grafts after an accident like this.

When you see the weather and the scenery, it's not surprising

that British doctors are following a well-trodden path Down Under.

1.2 million Aussies were born in Britain

and many more are of British descent.

100 miles up the coast from Sydney is the Newcastle base

of the Rescue Helicopter Service.

The team is sponsored by local businesses

but also gets funding from the Ministry of Health.

The man in charge of all the pilots

and crewmen is a former Royal Navy pilot.

'I came over to Australia back in 1998.'

'As a pommy, you're brought up seeing it as a place of opportunity'

and the climate, you can see from the climate here,

and for those of your guys who've flown with us,

they see it as the best cockpit in the world, the best office.

I love it. I'm now the chief pilot of the rescue service.

My job is to look after this base, and our base in Tamworth.

We have four helicopters and it's a great job.

Good team and a great unit to work for.

Today, Mike's team's been scrambled to rescue a boy

from an expat British family who's been crushed by a kitchen cabinet.

He was obviously trying to climb on it.

From the outside, luckily enough.

And he pulled it down on top of himself.

RADIO: Thanks. We're about a minute away

and just looking at a landing site, we might head for the sports field.

Let the car on scene know that.

Local paramedics are bringing the patient to a sports field

where the chopper can land.

-Hello.

-How are you?

-How are we?

-Lots of doctors, hey?

-Good.

This is Tamara, Jesse's mum.

Tamara was in another room, heard a loud bang, came out

and Jesse was on his back underneath a cupboard,

-probably about 30 kilo.

-JESSE SOBS

He's complaining of right maxilla pains,

-with the swelling around there.

-Can I have a look at your lip? Hey?

-How old are you?

-Say, "four and a half."

-Can you hold up fingers?

-Four and a half.

-Good boy.

-Four and a half?

-Have you got a brother or sister?

-"I have a twin brother."

-Mummy.

-OK.

Is that sore there? Turn your head to look straight up at the roof.

Jesse Mate's family is in the middle of moving house

and he was exploring his new home when the accident happened.

-You keep your eyes open.

-Mummy.

Is there any pain in the back here? JESSE SOBS

-Does that hurt about there?

-Does that hurt there?

Does that hurt where I'm pressing?

-OK.

-Big, brave boy, aren't you?

-All right, Jesse.

We'll wheel you over and you go for a ride in the big helicopter.

Mummy's coming with you.

Just so you know, we're going to be leaving Clarence Town very shortly

and we'll be at the John, one patient for A&E about 10:45.

I heard a bang and Jesse, he's got a twin brother,

he started screaming, I come straight out

and the pantry was on top of Jesse

and there was blood everywhere and I just threw the pantry off him

and he was knocked out and everything for about a minute.

At first, I thought he was dead.

I thought he'd died and it was just...absolutely terrible.

And then when he started to cry and everything,

I knew he was going to be all right but I still didn't know, so...yeah.

Yes, if you can get to John Hunter, please, that'd be great.

-PILOT:

-All right, mate.

The medics are still worried about Jesse's neck and the fact

he was knocked out could mean he may have a hidden head injury.

We've got a four-year-old male coming in.

He's had a 30 kilo pantry fall on top of him.

Had a LOC of approximately one to two minutes.

MIKE: 'Most of the team here have children of their own

'so there's a little bit of added pressure in-built with children

'that the people want to look after them a bit more

'so there's a bit more emphasis on achieving the goal.'

In just ten minutes,

Jesse and his mum are arriving at the equivalent of a major

trauma centre where he'll have a series of tests and scans.

The following day, Jesse is out of hospital

and back with his family helping them move into their new home.

So, you carry it carefully. You all right? Whoop, sorry, bud.

-He hasn't suffered any lasting damage.

-You all right with that one?

We were meant to do all the moving and everything the other day

when Jess had his accident

and I believe that Jesse has got up to go to the pantry to get

something to eat and pulled a bit too hard on the door handles

and because it was empty and everything and hadn't been

put in properly yet, it had come down and landed on top of him.

So, it was very scary.

Um... All that was going through my head was, "He can't die."

Yep.

This is going to be your room, boys. Where do you want your box?

-Over here? Whoop, raahh!

-Jesse has British roots.

His grandma moved to Australia from Portsmouth when she was 19 and

the family are planning a visit to the UK in the next couple of years.

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