Episode 8 Helicopter Heroes

It's one of the most beautiful, but dangerous,

places on earth.

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

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

And when Australians call out the flying doctor,

they'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.

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,

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, 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.

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 could 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 holiday crash means a tricky landing for the rescue helicopter's British pilot.

We'll keep an eye on that...

A gas explosion leaves a chef with a badly burned face.

Went to relight it, and a big bubble of gas... He'll be going to intensive care now.

And a factory worker has a serious head injury.

-Do you know what day it is today?

-Tuesday.

-Tuesday? It's Monday.

As Britain freezes in December,

the Australian summer is just getting underway.

With weather like this, it's not surprising that 90% of Aussies holiday in their own country.

At this time of year, the Pacific Highway is one of Australia's busiest roads.

It runs right down the east coast, from Brisbane to Newcastle in New South Wales

and then on to Sydney.

Not surprisingly, it keeps the medics and air crew of the Rescue Helicopter Service pretty busy.

Today the team, which is sponsored by local businesses as well as a major Australian bank,

has been called to an accident 60 miles northeast of their base in Newcastle.

Control, we're airborne.

ETA 12:30.

A caravan has overturned right in the middle of holiday traffic

and it's feared someone may be trapped.

OK, we didn't get much detail. It's just the old four-wheel drive

towing a caravan. Did you get a bit more on what was going on?

All we had was somebody hit a caravan

-and it tipped over.

-Right.

And the lady may have been trapped under the car.

British pilot Kevin Ratcliffe has been working in Australia for ten years.

He doesn't know exactly where the caravan is,

and he's still trying to find out if any land ambulances have made it through.

I've just asked for a scene update. There's no-one on scene yet.

Right, cos we were given two vehicles on the way. That's what I was given - 336 and 352.

If you can talk to the plods and ask whether they can tell us how far out of Bulahdelah they are,

and, you know, effectively confirming it's on the Highway.

That'll put us in the right place.

I used to fly in the Royal Navy.

I came out here without really an intention of getting back

into flying, because I'd been out of it for nine years.

Poor visibility and low cloud is typically what you might have to deal with in the UK,

and surprisingly enough, we still have the very same things out here.

The tall trees at the edge of the road

will make this a difficult landing for Kevin.

OK.

Can you see the scene that I'm looking at?

The police have got it cordoned off and we've got that area with the pull-up point.

..Under the bushes. We'll keep an eye on that.

Coming forward, 20.

And hold height, hold height.

Two foot off the deck.

They're happy, and you're clear now, guys.

It's surprisingly easy to lose control of a big caravan.

If it starts to sway, the driver will often brake too hard

and it ends up like this.

-Hello there.

-61-year-old Robyn...

Somehow they lifted the car up on its side, just enough to...

Just a simple flip over, although that's big enough for you.

I'm not sure how many times it flipped over.

And your first name?

Robyn? I'm John. Sounds like you've got a significant laceration on your head there.

We'll probably fly you down to the John Hunter Hospital, just because of what you've been through.

We're on the main Pacific Highway

north of Newcastle up to Brisbane.

About an hour and a half north of Newcastle.

Retired farmers Robyn and Barry Knight were attempting a 1,200-mile journey right across Australia.

from their home in Campsie to the Barossa wine valley near Adelaide.

They'd only travelled 120 miles

before the caravan tipped.

It's put an end to their trip to visit their daughter.

Take a deep breath again.

You chest feels all right there? No pain?

They've done a lot of work in the past five to ten years to make it all dual carriageway,

or mostly dual carriageway,

but as you can see from today's event, it's still a bit of a hazardous place.

Thankfully, at least you don't get so many head-ons,

because it's a divided road.

But in terms of our job,

as you can see, looking round at the countryside, quite often the road is cut through some interesting gullies.

So from an approach and departure point of view, it's quite hard work.

The gentleman's got some very minor neck injuries.

However, his wife's got some serious injuries,

chest and leg injuries.

We don't think they're life-threatening,

but they both need to be transferred to the John Hunter Hospital,

which is the major trauma hospital in this area,

so we're going to take them both down in the chopper,

and it's an hour-and-a-half drive versus a 15-minute flight.

Little bit more on that side, mate...

-Before the log roll?

-I think we'll have that one side to put him on.

The couple's other daughter is a nurse at the hospital they're being flown to.

We're taking you down the John Hunter Hospital.

-Okey-dokey. Have you spoken to her at all?

-Yes, we have.

-She's not a panicker?

-No.

-Cos at this stage, there's no need to. Lovely. Too easy.

Pilot Kevin now has a tricky takeoff ahead of him,

so he and the team can get Robyn to hospital for urgent brain scans.

If you fall seriously ill in or around Sydney

and need to be flown to hospital,

then you'll probably be rescued by and Ambulance Service helicopter.

And if that's the case, the chances are the doctor on board will be British.

We'll go and get together, and we'll probably be about 10 minutes.

Doctor James Gibson trained as an anaesthetist in Liverpool,

but for six months, he worked for the Air Ambulance in Glasgow.

From being a very small child going to the beach in Northumberland with my parents,

we always used to see the helicopters flying past

and always used to look at them a bit wistfully and think, "I'd love to do that."

INDISTINCT MESSAGE OVER RADIO

Glasgow is the base

for the Emergency Medical Retrieval Service,

which covers all of remote and rural Scotland,

from the tip of Shetland right down to Stranraer in the south,

so you're covering an area which is equivalent to flying from Liverpool to Paris.

So it's a huge area. That being said, it's about a tenth of the size of New South Wales.

'..rescue helicopter from Sydney, for a patient pick-up.

'You have a trolley for arrival...'

Because of the vast distances involved,

the air ambulance teams in Australia are often needed to transfer patients from hospital to hospital.

And that's what's happened today.

A restaurant chef with severe burns needs to be flown to a specialist centre.

He was involved in a gas explosion.

He went to relight it, and a big bubble of gas

surrounded him and caught fire, so it's effectively flash burns.

Isolated just to his face, so causing an awful lot of pain

and also maybe some damage to his eyes.

Alex Zhao was lighting the boiler at his family's Chinese restaurant

when it blew up.

One of his sons was with him when it happened.

When he light up the gas,

it all come...

on his face.

And just some oxygen...

Alex has been anaesthetised, ready for his trip to the helicopter.

OK, so on three again.

So, feet first over, then a bit southwards as we get over. On three.

One, two, three.

If you get blisters around your lips, your tongue, your airway,

you can go from a state where somebody is just complaining of pain

to where they can't talk, to where they're having difficulty breathing.

If it gets to that stage, then trying to rescue them

from that situation can be fraught with danger.

It's always distressing for families to see a close relative in this state.

We're going to take very good care of him.

It's 90 miles to the specialist burns unit at Concord Hospital in Sydney.

It would take at least two hours by road,

but the chopper can get there in less than 30 minutes.

After time goes on, after 12, 24 hours, and the blistering starts to appear

and the swelling comes,

people can really lose their facial features. Their faces can swell up like a big, puffy balloon.

And relatives find it very difficult to recognise their loved ones in those cases.

Down at Shoalhaven Hospital, they put him off to sleep with an anaesthetic. They've intubated him,

kept him ventilated. Obviously, this is very painful with all the swelling.

So we're keeping him asleep with the drug lorazepam

and he's getting a lot of morphine as well, for pain relief.

Alex is the head chef at the family restaurant

and the business depends on him making a rapid recovery.

HE SPEAKS CHINESE LANGUAGE

Looking at Alex now, it's hard to believe that two weeks ago

he was rushed to a specialist burns unit for treatment.

He was at the back of the restaurant, lighting the hot water system.

It was windy the day before, so it probably blew the pilot light out.

And he was holding onto the button, trying to light the flame,

and the pilot light wouldn't light,

so he thought it was maybe a gas problem.

So he left it for a bit, then he tried it again

and there must have been a gas build-up

and it exploded in his face.

His actual hair caught on fire.

And he used his... Luckily, he had a cotton shirt on,

and he put it over his head

to put the flames out.

My dad's a great chef.

THEY SPEAK IN CHINESE LANGUAGE

He says he's really good with his Chinese dishes,

even the more traditional ones,

but the Australian dish, he learns quick, and he's not too bad at it.

Alex can't wait to get back in the kitchen,

although he says he's missed going fishing much more than working.

400 miles southwest of Sydney,

right on the border of New South Wales and Victoria,

lies the town of Tocumwal.

It's a three-hour drive from here to the nearest major trauma hospital,

but that's not unusual in rural Australia.

Communities like this rely on volunteers to support the paid emergency services.

You're the first people on scene. How are you going to deal with the situation?

You're talking about the initial medical assessment.

Today, doctor James Milligan from Yorkshire is running a trauma first aid course.

So you start with the things that are going to kill them quickest

and then you move through it.

We're teaching a trauma course to volunteers,

who are often the guys who are first on scene

to some fairly major accidents out here.

Probably the airway is going to kill him first. If you're on your own and someone has a mouthful of vomit,

and they've been in an accident, you have to get them on their side.

Australia's a pretty big place.

They've got big areas and very large rural areas.

They haven't got the density to have full service

fire and rescue people working in all these rural communities,

and they're very reliant on volunteers to offer that service that we get used to in the UK.

Unlike the metro areas, where they've got the paid firies, the paid rescue...

all the paid ambos, the volunteers fill the gap

for the country people.

Just bring your bum over a little bit...

We've got two or three helicopters for the state of Victoria,

and we're right on the border.

They're always busy with something else, so we make do with what we've got.

Well done. You know, we knew what we were doing...

It was a bit better, yeah.

If it was a real-life rescue, we'd have cut some pillars to make more room,

so we weren't twisting his body...

It's recognised across the world that it's important for everyone to learn basic first aid skills.

The St John Ambulance in Australia recently launched a programme

to teach thousands of schoolchildren what to do in a medical emergency

and in the UK, there's been a high-profile TV campaign.

The first aid that gets taught in Australia will be the same first aid

that gets taught in the UK.

It's never very complicated. It's normally fairly straightforward things

that anyone can learn in a few hours,

which potentially could save somebody's life in the future.

Back at his day job with the CareFlight helicopter in Sydney,

doctor James is on his way to a factory

where first aid given immediately by colleagues

may well have saved a man's life.

For now.

It's very similar to some of the work particularly on the Yorkshire ambulances.

There's a lot of pressure there to get airborne quickly.

Here, it's slightly easier, because the type of aircraft they're using starts up a bit quicker.

The distance from the hangar to the helicopter is a bit shorter.

Little things like that just make seconds of difference, but all those seconds add up

and make it that little bit slicker.

The plan is to get airborne quickly and get the patient out there sooner.

Jason Dalton has a serious head injury,

but no-one's quite sure how he fell.

One guy just heard a big bang and saw him on the ground.

Whether he's fainted or had a fit, we're not quite sure at this stage.

Colleagues used their first aid training to check Jason was breathing

before calling 000, the Aussie equivalent of 999.

Landing site down here...

INDISTINCT RADIO MESSAGES

The Sydney CareFlight helicopter is always called in

when the patient has a head injury or has lost consciousness,

because there's a specialist doctor on board, like James, who can assess them.

Hey.

This is Jason. Now, Jason's approximately 40 years old...

Jason can't remember anything about his collapse,

which is a big concern.

Colleagues say he wasn't doing strenuous work.

He only started back at work today, and he would have been fitting up the guards or lights on the truck.

That's all he was doing today.

He'll run through things, making new frames, ready for the company to open back up.

-So you can't remember anything about what happened?

-No.

No? Where's it hurting you right now?

It's not.

-It's not hurting you now?

-No.

-Fine. OK, do you know where you are?

-I'm at work.

-You're at work.

Do you know what day it is today?

-Tuesday?

-Tuesday.

It's Monday. Monday.

And what were you doing this morning? Can you remember?

-No.

-No?

Anyone who is confused with a bang on the head,

we obviously start being worried about whether they've got some bleeding within the brain

or an injury to the brain itself.

That's high on our list of concerns.

It's very hard for us to do anything about that in the field,

so obviously, we need to get him into hospital fairly sharpish

so we can try and diagnose exactly what's going on.

I'll have a quick look, then we'll get the board in and get him on it.

Did you have anything to eat at lunchtime?

-Don't know.

-Fair enough.

How's your neck feel?

Is it all right?

Any pain down here?

No? How about down here?

Good man. Feel me doing that?

Can you feel that?

It's all right, mate, just having a little tickle.

You all right, mate? We'll just put you onto this board.

One, two, three...

Generally, if the transfer's going to be more 15 to 20 minutes,

then we'll use the helicopter. If it's going to be shorter, we can use the road ambulance.

If we do use the road ambulance, we have the advantage of being able

to do more practical procedures within the back of the ambulance.

The back of a helicopter is fairly restricted for that.

How are you doing?

You all right?

We're just going to do a quick trace of your heart in a sec.

Just to check how that's going, in case there's something going on that's made you collapse.

Because doctor James and paramedic Ben are travelling with the patient,

the land paramedic has to fly to hospital in the CareFlight helicopter.

It looks like she'll probably be applying for a job on the air ambulance very soon.

Three weeks after his mysterious collapse,

Jason Dalton is back at work.

I just heard a crack on the ground, which was when my head hit the ground,

which was me fracturing my skull, pretty much.

Um, then I was just lying down there.

A couple of the boys ran to grab some rags,

which was Mark and Dino,

to hold my head together while the ambulance came.

It was a pretty big impact.

There was probably about two litres of blood.

So, yeah, it was pretty, uh...

yeah, pretty hard.

Jason has English roots,

so he was quite pleased to be treated by doctor James.

So you felt absolutely fine this morning?

I think it's absolutely fantastic. I think they should bring more English people in here.

Not Pommies, more English people in here!

The old man's from Watford.

It's not clear exactly why Jason collapsed.

Doctors think it may have been because he was very dehydrated.

In Newcastle, 100 miles up the road from Sydney,

a couple whose caravan tipped over on the Pacific Highway

are being taken to hospital

by the Westpac Rescue Helicopter team.

It's a difficult takeoff for British pilot Kevin Ratcliffe,

who has to negotiate tall trees.

Come up on the left - I think that's a nice way out of this valley.

With two casualties on board the aircraft and temperatures pushing 40 degrees,

it's a bit hot and sweaty in the back.

We have a large laceration to the top of the head.

I haven't really examined the extent of it.

We'll be landing on the pad at time 13:22.

Barry Knight, who was driving the car, has only suffered cuts and bruises.

Paramedics are much more concerned about his wife Robyn,

who hit her head hard during the impact.

Although scans reveal she didn't have any bleeding in her brain,

she did have to stay in hospital for several days.

Nine days ago when Barry and Robyn set out along the Pacific Highway,

they were so excited about their epic road trip.

Probably take a week to come home,

so do it at a nice leisurely pace.

They'd planned to drive their caravan 1,200 miles

right across Australia to their daughter's home in the Barossa wine valley, near Adelaide.

Their journey was cut short when their caravan tipped over.

I've got a laceration to my scalp.

It's about 11cm long,

from the hairline back to the crown.

I've got 23 staples, so they had to

shave the hair away to do that and clean the wound

and irrigate it all,

and whatever.

The car travelling behind us,

the driver was a nurse, and she was kind of the first person.

She said, "You're OK."

And then a doctor came

and he said, "I can do what I can, but I'm a gynaecologist,"

so that was fun!

And then another doctor came along

and he was a plastic surgeon,

and then there was a third doctor and he was a GP, so...

They were all really good, and I think there were four nurses there as well,

four RNs as well,

so these were just people travelling on the Highway.

So we're very fortunate.

And you're clear, guys.

They were such a team, you know.

Everyone seemed to know what everyone was supposed to do

and it was just real teamwork.

The following day, Robyn had the staples in her scalp removed.

She and Barry say they'll attempt to visit their daughter again in a couple of months' time.

When you ask British doctors why they've chosen to work on the air ambulance in Australia,

for some, like Nick Roberts, the answer is simple.

I was surfing in England. I used to surf in the North Sea

up near Newcastle and Northumberland

and I always thought it'd be nice to come and surf in warm water

in Australia, so that was certainly a lifestyle aspect

which I was interested to enjoy, the beach lifestyle over here.

I've been here five years now.

I started my specialist training over here.

So I'm actually planning to stay long-term, probably for ever.

Today, doctor Nick and the team are heading down the coast, south of Sydney.

They've been called out to a 12-year-old girl

who's had an accident on a ride at the Jamberoo theme park.

We've come out to Shellharbour,

which is just south of Wollongong,

about 80km south of Sydney.

A young 12-year-old girl's been involved in some sort of go-kart

or ride-on vehicle incident,

and she's got some facial injuries

and possible abdominal injuries,

so we'll move her to a specialist paediatric trauma hospital.

My daughter was at Jamberoo and she was on a toboggan.

The person in front stopped.

She was in the middle, so she hit the person in front

and the person from behind came and hit her as well.

She's fractured her cheekbone here

and we're waiting to hear if there's any bleeding of the spleen.

It'll all look good when the swelling goes down.

-Yeah?

-Yeah, you'll be fine.

..While we stick on something...

Well, Shellharbour's only a small little hospital.

They don't have any paediatric surgeons here,

so I guess the concern is that

if she was to need any specialist paediatric surgery, she'll be in the right place

up at Westmead.

It's quite a long drive, so they've decided to use a helicopter to get her up there.

All right. You happy?

I'll go the other side.

-Better than the motorway anyway, mate.

-It is. It's loads better.

Breanna seems to be OK,

but doctor Nick is concerned that because she can't remember what happened,

she might have bleeding on the brain

or a fractured skull.

The danger with head injuries is they can be life-threatening very quickly

and there's this concern with head injuries of what we call a "lucid period"

which is where someone can appear fine but actually they have quite a serious bleed on the brain evolving.

For this reason, we like to, at minimum, closely observe a head injury in a hospital,

looking for decreasing levels of consciousness or developing neurological findings.

I've been on one of those in Queenstown in New Zealand.

-It's the only time I've been on one of them. Good fun, though.

-Yeah.

One of the reasons doctor Nick stays in Australia

is he can work half the time with patients like Breanna on the air ambulance,

and the other half in hospitals.

But he's conscious the NHS is losing out.

That is a problem,

and an expensive problem as well.

I mean, to think that I went through schooling in England,

university in England, and ultimately ended up providing

three years of service to the public service.

That's a problem for the NHS, and I feel bad about that, in a way.

I would have liked to have been able to work for them for a bit more.

And certainly, if there was more flexibility, I think more people would return.

One, two, three.

But the politics of medical care aren't a concern for 12-year-old Breanna.

All she wants to know is whether her broken cheekbone

will mean she can't pursue her life's ambition.

After lots of tests and a night in hospital,

Breanna is allowed to go home.

She still can't remember much about her accident.

I just like going on the rides.

I went on the Python,

the Funnel Web

and the Long Slide.

We think her face has hit the brake.

And with the second hit, she's been thrown off,

and that's when she's got the concussion and the head injury.

I was really excited

once they told me I was going in a helicopter.

Then when they said that

I get to look out, then we're just over the top of water.

Pretty cool!

Breanna's bump on her toboggan

left her with a fractured nose, a fractured eye socket

and a fractured cheekbone.

These are painful injuries,

but Breanna was more concerned about them stopping her doing the thing she loves.

I do contortion, ballet,

modern...

jazz, hip-hop...

I want to become a famous dancer.

When I found out I had a fractured face, I was really scared once I found out that.

I just thought of my dancing.

It was like, "Oh, no, what am I going to do?"

Because she's a dancer, she does a lot of shows and...

She's a show pony!

That's just what she wants to do.

Seeing her face like that was awful.

Just awful. Terrible seeing that.

But Breanna has been assured by doctors

that in a couple of weeks, not only will she be dancing again,

but when the weather clears up, she'll be able to join her friends on many more holiday outings.

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