Episode 9 Helicopter Heroes

It is one of the most beautiful but dangerous places on earth.

My name is Helen, I am one of the doctors.

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

And when Australians call out the Flying Doctor,

they are likely to be British.

And so is the pilot, paramedic and crewmen.

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

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

They say they got the bends from coming up here...

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 is that tummy pain now?

Now, like hundreds of medics every year,

he is swapping rainy Britain....

-It's wet.

-It is wet.

..for a life in the sun.

We're living right by the ocean, it's a beautiful spot.

Work's nice and relaxed, the atmosphere is great,

life probably couldn't be much better.

But it is a place where the nearest hospital can be 200 miles away

and the wildlife can kill you.

You ready?

Can I listen to your heart?

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

Today, a top rodeo rider takes a serious fall.

It appears as though he was riding a horse that's collapsed

and it has come down sort of onto his femur

and he's got a midshaft femur fracture.

There is a powerboat crash and the driver is missing.

The longer it goes on, the bleaker the outlook becomes.

And a rescue chopper is scrambled to the local dump.

They were searching with a beacon, I used my foot and I found it.

Australians are mad about swimming.

There are more pools built here per person than anywhere else

in the world.

But this love of water can have fatal consequences,

particularly for kids.

And here, drowning is now the most common cause

of accidental death for children under four.

'You'll probably be close to there now.

'You'll probably be first on the scene.'

It's a typical hot Australian summer day

and Dr James Milligan is heading up to the New South Wales coast.

A call has come in that a two-year-old has been found

floating in a garden pool.

Just a briefing on the situation.

There is a two-year-old child that has been pulled out of the pool

unconscious. The child is now screaming,

so we assume it must have some degree of consciousness.

Uh... We are going to be arriving on the scene about 4 minutes

after the first car, so we'll be there pretty early.

The girl has been pulled out of the pool and is breathing,

but she may still be seriously ill.

Front door's coming back, confirm left door is clear.

Patonga is known as the secret jewel of the central coast.

It is clear to see why.

Call to Operations. Rescue 24 making an approach into Patonga.

So, it sounds like the police will be transporting the baby.

It's coming over the wire now.

As their two-year-old patient is transferred to the landing site,

Dr James and paramedic Bob Lyall are already making plans.

Just have to work out which way you want to go.

If the kiddy has had a proper drowning,

then they probably need to go down the road.

If they've just fallen in and been a bit quiet afterwards,

then they can probably go to Gosford.

She was floating face down, so he doesn't know

whether she hit her head on the side of the concrete or whatever.

-OK.

-Got her out. The police said when they arrived,

cos they were five minutes in front of us,

she was a little bit unresponsive.

She's taken on some water and they've called for police

and ambulance assistance.

It's a worrying time for the family

when any small child falls in water like that, so, yeah.

So Grandad didn't have to do any mouth-to-mouth or anything?

Just pulled her out, she was breathing.

-But just a bit drowsy and a bit groggy?

-Yeah.

Can I have a listen to your heart?

Can I have a listen at the back? Who is this?

Very quiet, she's very shaken.

-That's Teddy.

-Teddy.

What do you reckon?

It's obviously pretty worrying stuff going to children who

are seriously ill, so there is some emotional stuff that is involved.

But from a medical standpoint, children, we like to

think of them as small adults, but they differ quite significantly

in how their physiology and things work

and the drugs that we give and the treatments that we offer,

so we have to start thinking on a completely different...

in a different way than we would with an adult.

So we'll just check her oxygen levels are right. But she looks super.

At the end of the day, I don't think... We're not too worried.

Whatever has happened has been pretty scary for her...and for you.

-She needs to be observed overnight.

-She needs to go to a hospital.

-And be observed.

-Think she needs to be dragged all the way to Sydney?

-I don't... In my view, no.

-They're not going to do anything.

When kids have been in the water, we are always a little bit worried

about what is going on, so we need to keep an eye on them

probably for at least the next 12 hours just to check that

everything stays OK.

But we are not so worried that we think

we need to take her to the kids' hospital.

-OK.

-I think that Gosford would be more than happy to deal with it

and look after her.

And that we don't have to put her through the stress

again in a helicopter, which sometimes can be good fun,

but when you can't explain what's going on,

it's terrifying as well.

Bella has made such an improvement that Dr James is happy

she can go to the local hospital for treatment.

She will be assessed there in their ED.

There sometimes can be secondary problems with drownings,

so generally we like to keep an eye on children

for a few hours afterwards, probably up to 12 hours after the instance,

so I imagine she'll be staying there tonight.

And if she is well, she will be going home in the morning.

Unfortunately in Australia,

because they have so many swimming pools and the weather is so nice,

children falling into swimming pools is a fairly common problem.

And it's something that's really taught quite well

and taught fairly early on to everyone within Australia,

sort of safety around swimming pools and dealing with those emergencies,

because unfortunately they are all too common.

-Me!

-All right, you show me how you swim.

The hospital stay was only precautionary.

It was an overnight stay because she had a test in the morning

just to make sure that she didn't have any sort of

a fit underwater.

And all the tests have come back really positive

and the doctors are all really happy to send her home.

Bella has always been confident around the water.

It really hasn't put her off too much.

The family is very grateful to the British doctor who

reassured them at a very worrying time.

Aren't you good!

He made me feel really reassured

and calm that she was being checked over by a doctor.

He was fantastic with her. He really considered, you know,

whether the trip in the helicopter was worthwhile

because it probably would have scared her, all the loud

noise of the helicopter, more than what it needed to have been.

Hey!

But it's Bella's grandad who's still badly shaken by what happened.

He has definitely taken it the hardest

because he was the one that was there.

And he didn't actually get to see her, um, through, you know,

with the ambulance and seeing Dr James,

so he didn't have that relief.

And he is still blaming himself.

And, you know, we just keep saying, "Thank God you were there.

"Cos if you weren't there, we wouldn't have her." So...

Australia may be less than 300 years old as a nation,

but it is keen to preserve its past,

and that includes the traditional skills that opened up

the continent to Europeans.

Getting set to go with our next competitor, this is Ashley Gibson,

a young man from Dubbo.

He works over there at the Dubbo Equestrian Centre.

Rodeo events in Australia can attract huge crowds.

And for those who climb into the saddle, it's big business.

The horse is called The Gambler.

Today, one former national rodeo champion has been thrown off

his horse and needs help from the air.

Flying the team up into the Hunter Valley, 120 miles north of Sydney,

is British chief pilot Mike De Winton.

This is an area famous for both its mining and its vineyards,

but it is also a big place for horses.

-That little flat there in the middle of the racetrack.

-Yep, got that.

We are at a place called Camberwell, which is

about 50 miles down the valley from the base,

to a gentleman who has fallen off a horse

and the horse's actually rolled on him, breaking his leg.

OK. Just squeeze both my hands for me?

OK. Nice and tight. OK, that's good.

Steve Ernst has competed in the National Rodeo Championships

ten times,

but today it was just a gentle ride at home that has left him

with a broken leg.

As far as I know, Steve was just working his mare

and she come down on him, landed on his leg and snapped it.

And he just rang me up on the mobile phone.

To say, "Come over and give me a hand."

But the paramedics discovered that not only has

he broken the biggest bone in his body,

Steve has also had a full heart transplant,

and that could cause serious complications.

You know, he has had a heart transplant.

He's got all these medications and all the stuff there.

You haven't taken all of those today, have you?

Yeah, I was late taking them.

-How's the pain, mate, like now?

-It's all right.

Yeah. We're going to move you around a little bit.

We might even just slip him a little more morphine, I think,

just before we move.

Obviously... You've still got a bit of pain there, obviously.

Oh, yeah.

This certainly isn't the first time Steve has had emergency

medical treatment.

The horses are all good, mate, they've gone up to the top pen.

As a professional rodeo rider, he has had a string of breaks,

strains and dislocations.

But this is the first time he has been flown to hospital.

He is a pretty stoic guy, so, yeah, it's going good.

One, two, three.

He is due to have a density scan,

so there might be some issues there with some fragile bones,

but it appears as though he was riding a horse that's collapsed

and then it has come down sort of onto his femur,

and he has got a midshaft femur fracture.

So, we're going to roll you over, mate,

and then we're going to move the spine board from underneath you.

For former Royal Navy pilot Mike,

this is a great chance to learn more about rodeo.

You don't still ride bulls, do you?

-No, no.

-Stopped that.

-Yeah.

-Too dangerous.

Take them horses instead.

No, I rode saddle broncos for years and I fought bulls,

I was a rodeo clown.

-Rodeo clown?

-Yeah.

-Even more dangerous.

Yeah, probably.

We are going to head back to the John Hunter Hospital,

about 25 minutes en route back there, and get him into the hospital

so they can fix him up.

'52-year-old male crushed by a horse.'

But as Steve is flown down the coast to hospital,

it leaves a big problem back on the ranch.

He has got 20 horses which need looking after.

I suspect he'll be out of action for at least three months.

Um...

Steve, he'll get through it, he'll just grin and bear it.

His character's fairly colourful.

But Steve is not keen on sitting around.

The next rodeo event is in less than a month

and he is determined to be there.

The demolition derby, the fireworks,

I cover all parts of it.

I want to be there and be part of that show,

which is in round about

three weeks' time. That's my aim,

to be fit enough to be back in the saddle

and to be able to announce the itinerary from the back of a horse.

Living by the sea isn't cheap in Australia.

A beach view in the smartest Sydney suburbs will set you back

several million pounds.

But Dr James Milligan and his Aussie partner Lee

still managed to find a home enjoying the sea-front set.

Now this is their doorstep.

But water plays a different part in James' working life.

The weather is that little bit warmer, so people are more inclined

to want to play and be near to the water.

It's not just kids, adults go out on the water in boats.

We have lots of problems with fishermen on rocks

falling into the water who can't necessarily swim,

and that also has fairly devastating consequences.

So it is something that we see far more readily here.

It is something that would be fairly rare to see in the UK.

We see very, very few drownings.

-Just straight ahead here, Jess?

-Clear left.

All the way along till the end of the river.

Today, Dr James is taking his turn on a ground ambulance,

as all of Sydney's flying doctors must.

Two guys and a boat have overturned.

They currently have found one of the occupants

and he is being taken to hospital as we speak.

They haven't found the second occupant,

so we've got fairly serious concerns for his welfare.

It has been over 12 minutes since the boat crashed.

The accident happened on the Georges River on the outskirts of Sydney.

The powerboat driver is missing.

Not for the minute, I don't think we've got a patient yet.

The missing man, 28-year-old Steven Antuch,

is a local celebrity - the holder of a major speed record

and one of Australia's fastest men on water.

-So... James. Nice to meet you.

-You know the story?

-Yeah, two guys on a boat?

-Yeah.

He was coming down here at warp speed, they flip the boat,

he has come out but hasn't seen the driver since it flipped.

His 29-year-old mechanic was thrown clear

and taken to hospital with minor injuries.

Now, the missing racer's brother has jumped into the water

and he is desperately diving for Steven.

Flying Doctor James can do little

but wait, as searchers struggle to find him.

They've currently got the boat out looking for the second occupant.

Hopefully, we will find him shortly, but the longer it goes on,

the bleaker the outlook becomes.

-RADIO:

-'96.5.

'Police say they are still trying to piece together what caused

'a crash on the Georges River.'

Emergency services never give up hope in the hour after

an accident like this.

Victims have been resuscitated after long periods underwater.

'Detective Inspector Glenn Fitzgerald...

'The location of the river, visibility was very difficult...'

The boat hasn't surfaced.

There is a chance the missing man is trapped in an air pocket.

But as the evening wears on, the outlook becomes bleaker,

and the ambulance service team is ordered back to base.

Unfortunately, we were on the scene for nearly an hour

and there was still no sign of him.

At that point, there is little that we are going to be able to do

to help him, so we have returned to base.

Steven Antuch's boat, capable of 100 miles an hour

and a familiar sight in river races, is found the following day.

Its driver's body is recovered by divers.

The mechanic guy who got flung out, he's a bit sore

and sorry for himself, but he is a very fortunate boy.

Unfortunately, Steven hung onto the steering wheel

and knocked himself out and drowned.

It was a terrible shock.

The sheer size of New South Wales means true wilderness

is never far away.

Whether it is bush walkers, mountain bikers or climbers, when people

get into trouble out here, getting help can be an impossible task.

Unless you have one of these.

PULSATING NOISE

A lot of bush walkers, a lot of hikers

and also canyoners go up.

A lot of them take this.

We've found a significant amount of people with beacons

who have been either lost or injured.

We can home in and then identify

and get somebody in there to find out what's wrong.

While they are hard to get hold of and hardly ever used in the UK,

these personal locator beacons are increasingly common in Australia.

And for many, they have meant the difference between life and death.

Here, there's much more remote areas.

I mean, a lot of people in the company here go do

a lot of trekking and hiking.

And they'll always take a beacon

because it is normally a significant time and distance from any help,

and this will actually get somebody to you pretty quickly.

Today, Mike is getting a call from the Beacon Control Centre.

We'll see if we can find it. Yep.

A passenger jet has detected a beacon going off

somewhere near Newcastle.

Yeah.

It could be a walker or sailor in trouble,

so now it is down to Mike and his team to find the beacon.

All right. All right. Thanks for that. Cheers.

'Departing base.

'Overhead Newcastle for a beacon search.'

In order to lock onto the beacon signal,

Mike has to climb to nearly 10,000 feet - that is

around four times higher than air ambulances usually fly in the UK.

'Passing 9,000 and still no signal at all.'

Then, there is a faint wobble.

It's the beacon.

Now it is a question of homing in on the signal.

'8,000, still getting a strong signal.'

But with an area of hundreds of square miles to cover,

it's a difficult job.

How you getting on?

No, I'm getting nothing.

INDISTINCT SPEECH

The crew has now been searching for nearly an hour.

But Mike has noticed the signal suddenly getting stronger,

but not from where they would expect.

Let's head down here. It's right underneath us.

Yeah, I reckon it's the dump.

Yep, it's directly under us.

The beacon signal seems to be coming from this rubbish dump

on the outskirts of Newcastle.

They've got no choice but to check it out.

We're just trying to locate the beacon with the hand-held homer.

It's obviously someone has probably thrown it out with their rubbish,

the beacon, and it's been turned on.

They've just got to eliminate

the activations that are genuine.

Obviously, this is probably an inadvertent activation,

but they still have to have it turned off.

Sort of wasted resources, really.

Someone obviously hasn't turned it off or they have turned it on

and just thrown it out for the sake of it,

knowing what full well will happen.

It's a bit disappointing.

Like, we're doing the job to find the beacon,

but it's a waste when it is at the dump.

The team must find the beacon because if another is activated in

the area, it'll be very difficult to home in on the genuine emergency.

But in an Australian summer,

tips are even less pleasant than those Mike left at home.

Very frustrating because we have just wasted countless hours of flying

and people's time.

There's another job they want us to go and do now anyway.

So, a little bit of forethought from people, and dispose of these

items correctly would save a lot of trouble.

Just pulled it out.

-Yeah.

-It's out, here.

Probably during the movement of the gear, this has gone off

and that's what has caused us to be operating for the last...

two and a bit hours.

We just found it and turned it off.

I know, I'm a star.

They were searching with a beacon, I used my foot and I found it.

HE LAUGHS

So all this technology you have,

the left boot does it perfectly.

No, we're going to take it back to the base

and we'll get it disposed of properly.

At the main ambulance service helicopter base in Sydney,

the triple zero call centre, the Australian equivalent of 999,

has scrambled Dr Peter Sherrin and the team.

'Helicopter Rescue 23.

'Just after a report or any further information.'

Dr Peter has been working here for 12 months.

He is about to return to the UK to complete his training.

I came out here, really... I took a year out

after my training

just to broaden my trauma experience

and hospital retrieval.

I've done a fair bit of critical care and anaesthetics back home,

but this is practising in a very different sort of arena.

Dr Peter and a team are on their way to Lithgow,

a small town 90 miles west of Sydney.

This is about, yeah, a 2.5, three hour drive from Sydney.

But by helicopter, we have a flight time of about 25 minutes.

'Rescue 23 landing at Lithgow.'

We've been called to a 10-year-old that has fallen

through a plate-glass window and has got some deep lacerations

with possible arterial injuries to the arms.

It is being controlled with some pressure bandaging and things,

but needs to go... There's potentially the vascular compromise,

he needs to go to a paediatric trauma centre.

So we're just going to pop in, have an assessment

and then transfer back to Sydney.

10-year-old Tully was at his dad's house

when he fell through the window, and he is flying with his son.

I was playing a game with my little sister

and I smashed through the window.

Tully's mum is driving to the Children's Hospital at Westmead

in Sydney and will meet him there.

So, this is Tully, he's ten years old.

At approximately 4:45 this evening, he's basically fallen through

a plate-glass window, both hands, and has sustained three deep

lacerations and no other obvious injuries.

He has otherwise been stable both from a cardio

and respiratory points of view and GCS 15 throughout.

Dr Peter is handing Tully over to another Brit.

Dr Simon Binks is an anaesthetist who emigrated to Oz

with his young family after falling in love

with the lifestyle.

I came out to Australia

briefly about ten years ago for two years as a junior doctor

with my wife. We never really got Australia out of our system.

We went back home.

I was last an emergency department consultant in Cheltenham and Gloucester.

I loved that, but the sea, the sand,

the weather attracted me to come back out here.

So, I've been on here for just under a year now.

And I have got a small family, they love it.

Spend a lot of time on the beach.

The work is a little bit more challenging here.

The emergency department tends to have a bit more scope of practice.

They tend to do a little bit more with their patients

than we used to do in the UK.

He's got good capillary, can turn all fingers.

Can I get you to do a few things, mate?

Can you do that with your hand?

Yeah. Can you pull this back for me like that?

And spread your fingers.

And which one was bleeding the most?

Did you get a feeling which arm was worse?

-The bottom one on this one.

-The bottom one here?

Yeah. This one was the biggest, but that was bleeding the most, I said.

OK.

Tully's mum is suffering from delayed shock.

The accident happened at his dad's house

and it was a couple of hours before she got to see Tully for herself.

I'm sorry, I'm just trying to...

When it was bleeding, was it squirting,

like nearly hitting the roof?

-It was squirting, but not hitting...

-Not hitting the roof.

Dr Simon and the team need to see how deep Tully's wounds are

so they can decide if he needs an operation immediately.

We have examined Tully's wound with some sedation here

in the emergency department. We can't treat his wounds here.

They are too deep.

We were predicting that from the descriptions we'd heard.

So he has been examined by the surgeon here

and he needs to go to the operating theatre for general anaesthetic

and a full exploration and closure of those wounds.

They're actually quite deep.

Before his operation, Tully needs a series of X-rays to check

there aren't any shards of glass left in his arms.

That would cause further complications

and could slow his recovery.

Now Tully is about to be taken to X-ray by yet another Brit.

Nurse Jill Gregory has lived in Oz for more than 20 years.

So, is this the happy gas or is this just me?

That's just oxygen.

-You've just had a lot of drugs that make you feel a bit weird.

-Oh.

I wish it could stay like that for ever and ever.

The pain killer ketamine is making Tully a bit more chatty

than before.

-How is your day going?

-Very good, how is your day?

-Very good.

-That's good.

-So, we're going to do X-rays

of both of his arms, just to see if we can see any

glass in the wound and see if there is any damage to the bones.

We're not going to take the dressings off

because of the risk of bleeding, possible bleeding.

Tully, we're just going to do your right arm first, OK?

Do we have to take the bandage off?

-No, we're not going to take the bandage off.

-Yay!

The X-rays show that Tully hasn't broken any bones

and there are no glass splinters in the wounds.

That means surgeons can operate to close the deep gashes

in Tully's arms.

A week is a very long time when you're ten years old.

And that is how long it has been

since Tully has been able to move his arms properly.

Can't feed himself, but, yeah,

it's kind of like permanent Gangnam Style, we've decided,

he should be a mascot for the Gangnam dance style.

I was jumping on the bed and then I kind of fell

and smashed through the window,

but it didn't hurt because I was too shocked... I was in shock.

Tully did manage to keep his arms still enough for the wounds to heal.

One month after the accident,

both splints were taken off and he's hoping he will be fit enough

to start playing football again at the beginning of the season.

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