0:00:03 > 0:00:07If you are critically or seriously injured, seconds count.
0:00:07 > 0:00:11And in Britain's biggest county, you can be a long way from help.
0:00:11 > 0:00:14- Where's the patient? - Stuck under the car!
0:00:14 > 0:00:17The Yorkshire air ambulance flies at 150mph,
0:00:17 > 0:00:21and thanks to its speed, hundreds of patients are alive today,
0:00:21 > 0:00:25saved by a highly skilled team of doctors and paramedics.
0:00:25 > 0:00:27- Stand clear, everybody. - Keep going, mate.
0:00:27 > 0:00:31It covers some of the UK's most rugged landscapes -
0:00:31 > 0:00:34turning roadsides into operating theatres.
0:00:34 > 0:00:37We're going to pop him off to sleep with an emergency anaesthetic, OK?
0:00:37 > 0:00:41- And town centres into helipads. - Just behind you, Tim.
0:00:41 > 0:00:44And every day the Helimed team's skill,
0:00:44 > 0:00:47speed and courage is saving lives.
0:00:56 > 0:01:00Today, on Helicopter Heroes, a man has been crushed under
0:01:00 > 0:01:04a giant crane, but the cause of some of his injuries is less obvious.
0:01:04 > 0:01:07He just dropped to the floor like a sack of spuds, you know.
0:01:07 > 0:01:12A teenage driver gets a new wonder drug from the front line of war.
0:01:12 > 0:01:15If we give this it will cause clots to form and arrest that bleeding.
0:01:15 > 0:01:19And an industrial accident leaves a worker blind.
0:01:19 > 0:01:20Can his sight be saved?
0:01:20 > 0:01:22He can't see at all, it's just black.
0:01:28 > 0:01:30Working in the skies is a dangerous job
0:01:30 > 0:01:33and the Helimed team isn't alone up here.
0:01:33 > 0:01:36The cranes that dominate our cityscapes are vital
0:01:36 > 0:01:38for construction companies.
0:01:40 > 0:01:43But working with them has its risks.
0:01:43 > 0:01:46And today, Helimed 99 is heading for the market town of Morley,
0:01:46 > 0:01:48just outside Leeds.
0:01:49 > 0:01:51On our right, three o'clock.
0:01:51 > 0:01:5826-year-old Paul Davey was preparing a mobile crane when he was trapped.
0:01:58 > 0:02:02The ambulance service's hazardous area response team was on the scene
0:02:02 > 0:02:06within minutes, and Paul is already receiving medical treatment.
0:02:06 > 0:02:09One male trapped between two wagons. Rolled back...
0:02:11 > 0:02:15Paul has been crushed between a lorry and a crane.
0:02:15 > 0:02:18Workmates heard him screaming, ran to his aid
0:02:18 > 0:02:20and managed to separate the two vehicles.
0:02:20 > 0:02:22He was screaming, yeah. I just panicked.
0:02:22 > 0:02:24I was looking for the brake but I couldn't find it.
0:02:24 > 0:02:28So I've just come round to the vehicle and reversed it back.
0:02:28 > 0:02:30Just to let him free of it, really.
0:02:30 > 0:02:33He were in pain, you could tell he were hurt, like.
0:02:33 > 0:02:35Air ambulance doctor, Tim Moll
0:02:35 > 0:02:39and paramedic Dave Appleby must assess their patient quickly.
0:02:39 > 0:02:42It's likely that he has severe internal injuries.
0:02:42 > 0:02:45- From the mechanism in his pelvis, he's got a bruise over his pelvis as well.- Right.
0:02:45 > 0:02:51- We'll get him out and have a look at him.- Can I just sneak through, chaps?
0:02:52 > 0:02:55As Paul was pinned between the two vehicles,
0:02:55 > 0:03:00part of the lorry's metal bodywork actually bent around his pelvis.
0:03:00 > 0:03:04We'll get this out the way and get the T-Pod on...
0:03:06 > 0:03:11Understandably, Paul is in a lot of pain,
0:03:11 > 0:03:13but something is puzzling Dr Tim.
0:03:13 > 0:03:18Paul has obviously been in a major accident at some point in the past.
0:03:19 > 0:03:22Listen, you have to breathe deeply or it won't work.
0:03:22 > 0:03:26That's it, nice, slow deep breaths.
0:03:26 > 0:03:28The team is worried.
0:03:31 > 0:03:33Paul could be bleeding internally.
0:03:35 > 0:03:39And with crush injuries like this, it could kill him.
0:03:39 > 0:03:42He's not had the handbrake on in the cab and it's rolled forward
0:03:42 > 0:03:46and crushed him against the crane at the side.
0:03:46 > 0:03:49I was at the back of the trailer with Daniel
0:03:49 > 0:03:52and it all went bad really and crushed him.
0:03:52 > 0:03:54Workmates leapt to Paul's aid.
0:03:54 > 0:03:58They managed to separate the two vehicles but it was too late.
0:03:58 > 0:04:00The damage had been done.
0:04:00 > 0:04:02I've come round and reversed the vehicle
0:04:02 > 0:04:05and he just dropped to the floor like a sack of spuds, really.
0:04:05 > 0:04:08This lad here has helped him to get out of the way of the vehicle.
0:04:08 > 0:04:11Dr Tim Moll gives Paul a dose of ketamine.
0:04:11 > 0:04:15This is a very strong painkiller which works by interrupting
0:04:15 > 0:04:17the pain signals travelling to the brain.
0:04:17 > 0:04:19Paul, open your eyes.
0:04:19 > 0:04:22All right, Paul. Relax. Relax.
0:04:23 > 0:04:27Paul desperately needs life-saving surgery in hospital,
0:04:27 > 0:04:31but first, the team must make sure he is fit to fly
0:04:31 > 0:04:34and that means stabilising his shattered pelvis.
0:04:43 > 0:04:46There may be few beneficiaries of war
0:04:46 > 0:04:48but medical science is one of them.
0:04:48 > 0:04:51Millions of civilian patients benefit from lessons learned
0:04:51 > 0:04:52on the front line.
0:04:52 > 0:04:56And the Helimed team uses several life-saving techniques
0:04:56 > 0:04:59pioneered in recent conflicts.
0:05:02 > 0:05:06The war in Afghanistan is never far from the minds of thousands
0:05:06 > 0:05:08of families in North Yorkshire.
0:05:10 > 0:05:12Most recruits do their basic training here
0:05:12 > 0:05:15and Catterick is the British Army's biggest garrison.
0:05:15 > 0:05:18But today, some of the lessons learned by the military
0:05:18 > 0:05:22in the faraway province of Helmand in Afghanistan,
0:05:22 > 0:05:25are about to come home in an unusual way.
0:05:25 > 0:05:28Helimed 98 has been scrambled to a crash in the Dales.
0:05:28 > 0:05:32- That is where we are going then. - Yeah, no problem. OK, can you take us, please?
0:05:32 > 0:05:34They've got a car that's rolled.
0:05:34 > 0:05:37The female driver's trapped.
0:05:37 > 0:05:40They've called me to say she has a low BP, low blood pressure.
0:05:40 > 0:05:44Obviously, she could be bleeding internally.
0:05:44 > 0:05:47- Your bearing is 265, please.- Sure.
0:05:47 > 0:05:50Internal bleeding is a killer.
0:05:50 > 0:05:53But air ambulance paramedic Graham Pemberton,
0:05:53 > 0:05:55has a new weapon in his armoury.
0:05:55 > 0:05:59A new drug. It is the opposite of the thrombolytics we used to give
0:05:59 > 0:06:02to people who had a heart attack, which would stop the blood
0:06:02 > 0:06:07from clotting and stop the heart attack from getting any worse.
0:06:07 > 0:06:10We've now got a drug which does exactly the opposite
0:06:10 > 0:06:14and encourages the blood to clot so it stops them bleeding out.
0:06:14 > 0:06:16But the weather is against them.
0:06:16 > 0:06:20The hilltops of the Dales are swathed in low cloud,
0:06:20 > 0:06:22blocking the route to the crash scene.
0:06:22 > 0:06:26OK, what about... No low ground left or right there. Where are we?
0:06:26 > 0:06:31- The lowest is... We are here... - OK, yes.- We followed the road, but it is...
0:06:31 > 0:06:35We could go straight back there, couldn't we?
0:06:35 > 0:06:38- Helimed 98 receiving? - 98, go ahead, Dave.
0:06:38 > 0:06:41I've spoken to the crew on scene, they said they can see the hilltops
0:06:41 > 0:06:44from where they are, Graham, with about 5K visibility, over.
0:06:44 > 0:06:49Roger, thanks, Dave. Visibility is not looking too bad now.
0:06:49 > 0:06:52We've got a bit further on. We have an ETA now of six minutes. Over.
0:06:52 > 0:06:53Roger, thank you.
0:06:53 > 0:06:56The weather at the accident scene may be good
0:06:56 > 0:07:00but they are having to take a long diversion over lower ground.
0:07:00 > 0:07:03Should be on the nose, a mile.
0:07:03 > 0:07:05A visual with something there on the left?
0:07:05 > 0:07:07- Yes, visual at the scene, yes. - Yes, we've got it.
0:07:07 > 0:07:10But at last, they have made it.
0:07:10 > 0:07:13Their patient has been freed from her wrecked car,
0:07:13 > 0:07:16but her blood pressure is still worryingly low.
0:07:18 > 0:07:21- Is it hurting down here? - Charlotte Atkinson is 19.
0:07:21 > 0:07:25She is a carer who was on her way to look after an elderly lady near
0:07:25 > 0:07:30the village of Austwick when her car crashed into a dry stone wall.
0:07:30 > 0:07:33She's in quite a lot of pain in her pelvic area.
0:07:34 > 0:07:38And Graham's just assessing her, whether we are going to give
0:07:38 > 0:07:41her TXA and we're going to package her and take her.
0:07:41 > 0:07:45Hiya, my name's Graham, I'm a paramedic on Helimed 98.
0:07:45 > 0:07:47I've got a 19-year-old female.
0:07:47 > 0:07:49She has hit a dry stone wall
0:07:49 > 0:07:52and it looks like some of the stones have come through the car.
0:07:52 > 0:07:55She was found by a passer-by unconscious.
0:07:55 > 0:08:01Her initial obs were she was tachycardic with a blood pressure of 95/55.
0:08:01 > 0:08:05Graham calls doctors at Leeds General Infirmary.
0:08:05 > 0:08:10TXA or Tranaxemic Acid, will help Charlotte's blood clot more easily,
0:08:10 > 0:08:14helping close the vessels that are leaking into her abdomen.
0:08:14 > 0:08:17But I'm just wondering whether or not to give her some TXA anyway,
0:08:17 > 0:08:20because we've got a 17 minute flight in
0:08:20 > 0:08:22and we have yet to get her into the helicopter.
0:08:24 > 0:08:28An off-duty policeman and a member of the public stopped to help her.
0:08:28 > 0:08:32They gave some good help and they got a good location for us
0:08:32 > 0:08:34- to attend very quickly. - Your lower back hurts?
0:08:37 > 0:08:40We were fortunate enough to be able to get the air ambulance,
0:08:40 > 0:08:44given the cloud cover. We were lucky.
0:08:44 > 0:08:46And she'll be going to a good trauma unit at LGI.
0:08:47 > 0:08:51Graham knows that even with the team's new wonder drug,
0:08:51 > 0:08:53Charlotte's life is in real danger.
0:09:04 > 0:09:07It's terrifying to think how a freak accident can
0:09:07 > 0:09:09result in the loss of your eyesight.
0:09:09 > 0:09:12But there is a frightening number of ways that can happen.
0:09:12 > 0:09:16Some of them so rare few doctors have experience of them.
0:09:20 > 0:09:24We just had reports of an industrial incident down near Rotherham
0:09:24 > 0:09:29in South Yorkshire. It's a bit vague at the moment.
0:09:29 > 0:09:33Apparently, somebody may be trapped in some kind of machinery.
0:09:33 > 0:09:36And they may have sustained a serious head injury, query,
0:09:36 > 0:09:38they are unconscious at the moment. So...
0:09:38 > 0:09:41Information is quite limited but on the information we've got,
0:09:41 > 0:09:45it does sound like it could be potentially quite a serious incident.
0:09:45 > 0:09:49The paramedics are regularly called to industrial accidents
0:09:49 > 0:09:52and know that big warehouses often mean big machinery,
0:09:52 > 0:09:55with the potential for big injuries.
0:09:55 > 0:10:00We've got a car down near one o'clock now. A single car.
0:10:00 > 0:10:04It's ideal to park there just on the hard standing there.
0:10:04 > 0:10:06At this packaging warehouse,
0:10:06 > 0:10:11employee Stephen Neesam has been crushed by machinery.
0:10:11 > 0:10:13I'll shut this down because there's people on the scene.
0:10:13 > 0:10:14Yeah, the crew is inside.
0:10:14 > 0:10:19Just entering an environment like this to find a patient is dangerous.
0:10:19 > 0:10:22The warehouse is filled with huge rolls of paper
0:10:22 > 0:10:25and the heavy machinery used to move it around.
0:10:25 > 0:10:29All that we got was that it was an industrial accident that, er,
0:10:29 > 0:10:32a male had been crushed in some kind of machinery.
0:10:32 > 0:10:36It's on some sort of lift that seems to have malfunctioned
0:10:36 > 0:10:38or there's some fault with it.
0:10:38 > 0:10:42Fortunately, land paramedics got to Stephen quickly and freed him.
0:10:42 > 0:10:45His chest was crushed in the accident,
0:10:45 > 0:10:48but strangely he's lost his vision in both eyes.
0:10:48 > 0:10:50Can you manage to open your eyes then, Stephen?
0:10:50 > 0:10:52Honestly, I don't know whether they're open or not, mate.
0:10:52 > 0:10:57- I can't tell you. If I'm flickering them...am I flickering them?- Yeah.
0:10:57 > 0:10:59But I think my eyes are full of dried blood.
0:10:59 > 0:11:00Are my eyes full of blood?
0:11:00 > 0:11:04Basically a bit of machinery has come up and trapped this guy.
0:11:04 > 0:11:08He's got a lot of bruising, and a lot of blood around his face.
0:11:08 > 0:11:10The main concern at the minute is that, although his eyes
0:11:10 > 0:11:15are open or partially open, he just can't see at all. It's just black.
0:11:15 > 0:11:17So obviously we need to get that checked out.
0:11:17 > 0:11:20So, the nearest hospital for us is Sheffield Northern,
0:11:20 > 0:11:23which has got some services to look at people's eyes
0:11:23 > 0:11:26so we'll take him with us and see what's occurring.
0:11:27 > 0:11:31- Where is it hurting in your chest? - It's just...it's here, mainly.
0:11:31 > 0:11:33It's just like an ache.
0:11:34 > 0:11:37The weight of the machine which crushed his chest
0:11:37 > 0:11:40appears to have raised Stephen's blood pressure so much,
0:11:40 > 0:11:42it's burst vessels in his eyes.
0:11:42 > 0:11:45It's a rare but very serious condition.
0:11:49 > 0:11:53Neither Daryl or Tony have seen this condition before,
0:11:53 > 0:11:54but they can help.
0:11:54 > 0:11:57Getting him to a specialist hospital as soon as possible
0:11:57 > 0:12:01will give him the best chance of regaining his sight.
0:12:02 > 0:12:04He's got quite significant facial injuries
0:12:04 > 0:12:07and he's actually lost vision in both eyes.
0:12:08 > 0:12:14We're bringing him in from Wath so flying time is approximately,
0:12:14 > 0:12:17probably with you within the next 10 minutes or so.
0:12:17 > 0:12:19Finally, a glimmer of hope.
0:12:19 > 0:12:21Now he's out of the dark warehouse,
0:12:21 > 0:12:24Stephen thinks he can detect some movement.
0:12:24 > 0:12:26- Somebody's just climbed in. - Yes. I have.
0:12:26 > 0:12:28And somebody is stood by the door now, aren't they?
0:12:28 > 0:12:30- Yep.- Yes. I've just got your outline.
0:12:33 > 0:12:36- Better than you were saying before. - Yeah, and have you just climbed up?
0:12:36 > 0:12:39- I have, mate.- Yeah, yeah, I can see your silhouette.
0:12:41 > 0:12:45You're moving your head about, your head's just above me.
0:12:45 > 0:12:48All right, OK, still clear to your left. Stay on the right here, Tim.
0:12:48 > 0:12:52OK, I'll just go straight up and turn my nose to the right.
0:12:52 > 0:12:55Stephen has flown to Sheffield, where he's immediately
0:12:55 > 0:12:59transferred to the eye department of the Hallamshire Hospital.
0:13:01 > 0:13:05It's here surgeons carry out a very rare procedure to relieve
0:13:05 > 0:13:08the pressure in his eyes and save his sight.
0:13:08 > 0:13:12I was concerned of course but his vision was dropping,
0:13:12 > 0:13:15and we know that in this kind of situation, you probably have
0:13:15 > 0:13:18a window of about an hour to try
0:13:18 > 0:13:22and relieve the pressure, to have a chance of restoring the sight.
0:13:22 > 0:13:27You make a little cut in the lower lid on the outer side here
0:13:27 > 0:13:31so that the lid basically flops and is not supported by anything,
0:13:31 > 0:13:34and it just allows all the pressure to come forward.
0:13:34 > 0:13:37These tomatoes aren't growing very well,
0:13:37 > 0:13:40but never mind, I'm sure they'll come on.
0:13:40 > 0:13:42Peapods for your mum.
0:13:42 > 0:13:43And within a few days,
0:13:43 > 0:13:46he's back home with his eyesight fully restored.
0:13:47 > 0:13:50Yeah, they look like they're growing well as well.
0:13:50 > 0:13:53He just cut down the side of my eyes with a pair of scissors
0:13:53 > 0:13:56and instantly this one came...
0:13:56 > 0:13:59When it came down, I could see around the room straightaway.
0:13:59 > 0:14:01It was more or less instantaneous.
0:14:01 > 0:14:02My sight came straight back
0:14:02 > 0:14:06and I was amazed to see how many people there were in the room.
0:14:06 > 0:14:09Sometimes they're a bit awkward because they're prickly...
0:14:09 > 0:14:12'My daughter has got her prom night coming up. I wouldn't have seen her going to that...'
0:14:12 > 0:14:14I wouldn't have seen her at her wedding.
0:14:14 > 0:14:17I would've been there, but that mere thing,
0:14:17 > 0:14:19it's such a big disability.
0:14:19 > 0:14:23It was the speed of Helimed 99 and A&E staff that put
0:14:23 > 0:14:25Stephen in the hands of an eye surgeon
0:14:25 > 0:14:28within an hour of his accident.
0:14:28 > 0:14:33Today Stephen is returning to the Hallamshire for a checkup.
0:14:33 > 0:14:36- Hey!- Hi!- Hello, Stephen, nice to see you again.
0:14:36 > 0:14:39- I suppose the comment would be it's good to see you again.- Yeah.
0:14:39 > 0:14:42And his surgeon has something to tell him
0:14:42 > 0:14:45about the procedure that saved his sight.
0:14:45 > 0:14:49That was the first time I'd ever done it as an emergency.
0:14:49 > 0:14:54I think the fact the A&E consultant realised they needed
0:14:54 > 0:14:57to call me early on, that it was me, that I had a good team here
0:14:57 > 0:15:01helping me get things ready, I think they were all on our side.
0:15:01 > 0:15:03So unusual was the operation,
0:15:03 > 0:15:0740 hospital doctors crowded in to watch Dr Mawer at work,
0:15:07 > 0:15:11and medical photographs were taken to be used in training.
0:15:11 > 0:15:13Stephen's case was as rare as they come.
0:15:13 > 0:15:17It's just basically getting the scissors in, and having to do
0:15:17 > 0:15:22a little cut on the lower lid there to release all the pressure.
0:15:22 > 0:15:26It's quite shocking, really, to see the actual state of my eyes.
0:15:26 > 0:15:31I've seen some of the stills when I initially arrived at A&E,
0:15:31 > 0:15:34but to see the cuts and the blood
0:15:34 > 0:15:38coming out and the pressure, it's quite shocking really.
0:15:50 > 0:15:53A major traumatic injury is something most of us
0:15:53 > 0:15:57suffer at worst once-in-a-lifetime, but there's an unlucky few
0:15:57 > 0:16:02who find themselves in A&E twice in a relatively short time
0:16:02 > 0:16:05and that poses a problem for the paramedics trying to treat them.
0:16:07 > 0:16:11In the town of Morley, just south of Leeds, Paul Davey, a worker
0:16:11 > 0:16:15at a plant hire firm, has been crushed between a lorry and a crane.
0:16:15 > 0:16:16Is the pain easing off a bit?
0:16:16 > 0:16:18He's been working on a heavy goods vehicle,
0:16:18 > 0:16:21which has rolled for whatever reason.
0:16:21 > 0:16:24It's took him with it and looks to have given quite substantial
0:16:24 > 0:16:28pelvis and lower leg injuries, as well as a fracture.
0:16:28 > 0:16:31It's quite a range of injuries there that could prove
0:16:31 > 0:16:35life-threatening so we need to get him to hospital, get him stabilised.
0:16:35 > 0:16:37Once the ketamine kicks in,
0:16:37 > 0:16:40hopefully we'll be able to manipulate them a little bit better.
0:16:40 > 0:16:44We'll take this out and we're going to put our scoop on him, all right?
0:16:44 > 0:16:45Yes? OK.
0:16:45 > 0:16:49Moving Paul from this tight spot isn't going to be easy.
0:16:49 > 0:16:52The team use a split stretcher called a scoop.
0:16:54 > 0:16:57Former RAF officer Dave Appleby takes charge.
0:16:57 > 0:17:00He knows the extent of Paul's internal injuries
0:17:00 > 0:17:02will be revealed in hospital,
0:17:02 > 0:17:06but he's still puzzled by the extensive scarring to his legs.
0:17:06 > 0:17:10Paul is loaded onto a land ambulance for the short journey to the
0:17:10 > 0:17:14chopper. Here it emerges that this isn't his first brush with death.
0:17:14 > 0:17:18Do you have any medical problems at all that you see a doctor for?
0:17:18 > 0:17:21Are you completely fit and well normally?
0:17:21 > 0:17:23MUFFLED: I was blown up in a roadside bomb in Iraq in 2007.
0:17:25 > 0:17:28- A bomb in Iraq in 2007?- I was blown up in a roadside bombing.
0:17:28 > 0:17:31Oh, you were in a roadside bombing? Military?
0:17:31 > 0:17:33- Did you sustain any permanent injuries from that?- Yeah.
0:17:33 > 0:17:36- I've seen a scar on your knee.- Ahh!
0:17:36 > 0:17:38Paul was travelling in one of the Army's infamous
0:17:38 > 0:17:41Snatch Land Rovers when his convoy was hit
0:17:41 > 0:17:44by an improvised explosive device.
0:17:44 > 0:17:47So he's fit and well normally. He was blown up in Iraq.
0:17:47 > 0:17:50He was roadside bombed so he's not very lucky, is he?
0:17:50 > 0:17:53Getting information about Paul's past injuries will be essential
0:17:53 > 0:17:56for the surgical team in hospital, and it turns out
0:17:56 > 0:17:59Paul's legs are still peppered with fragments of shrapnel.
0:17:59 > 0:18:02We're just going to start putting you in the helicopter, OK?
0:18:02 > 0:18:04Just watch that arm, Pete.
0:18:06 > 0:18:09Today, ex-squaddie Paul will be travelling with former Army pilot
0:18:09 > 0:18:11Chris Attrill.
0:18:11 > 0:18:15The flight to the Leeds General Infirmary will take just minutes.
0:18:19 > 0:18:22This is the second time Paul has been critically injured,
0:18:22 > 0:18:26and this time his recovery is in real doubt.
0:18:35 > 0:18:38Back in the Yorkshire Dales, injured motorist Charlotte Atkinson
0:18:38 > 0:18:41is a long way from hospital, and the paramedics
0:18:41 > 0:18:45caring for her are concerned that her condition may be getting worse.
0:18:47 > 0:18:52Paramedic Graham Pemberton is banking on a new drug called TXA to
0:18:52 > 0:18:57staunch the internal bleeding that is threatening his patient's life.
0:18:57 > 0:18:59This is a tranexamic acid.
0:18:59 > 0:19:03This actually causes blood to clot so, because her pressure is starting
0:19:03 > 0:19:07to fall again and her heart rate is going back up, it suggests she's
0:19:07 > 0:19:10actually still bleeding actively somewhere. So if we give her this,
0:19:10 > 0:19:15it'll cause the clots to form and arrest the bleeding more effectively.
0:19:15 > 0:19:19We put it into a fluid and then it's infused over 10 minutes.
0:19:21 > 0:19:24Charlotte's seriously ill but now she's safely in the hands
0:19:24 > 0:19:28of the Helimed team, the police have other priorities.
0:19:28 > 0:19:30The traffic has managed to get round one of the local villages
0:19:30 > 0:19:33so we've got a bit of a diversion on at the minute, so hopefully
0:19:33 > 0:19:37we'll get it cleared before the real traffic starts this morning.
0:19:37 > 0:19:40The A65 is a major holiday route to the Lake District,
0:19:40 > 0:19:42and this is a bank holiday.
0:19:42 > 0:19:45At last the road can be reopened.
0:19:45 > 0:19:48OK, just go parallel with the road to our left.
0:19:50 > 0:19:53Many wounded soldiers owe their lives to TXA
0:19:53 > 0:19:57but this is the first time it's been used by the Helimed team.
0:19:57 > 0:20:01It's come mainly from the military sort of thing, Afghanistan
0:20:01 > 0:20:04and Iraq, where they've give them much more aggressively
0:20:04 > 0:20:07and it was shown conclusively that giving this drug within
0:20:07 > 0:20:11three hours of injury saves a large number of lives.
0:20:12 > 0:20:15Graham fears Charlotte has smashed her pelvis.
0:20:15 > 0:20:20Injuries like this can quickly lead to patients bleeding to death.
0:20:20 > 0:20:23From experience, the patients that have an internal bleed,
0:20:23 > 0:20:26it's quite frustrating for us as paramedics that there's
0:20:26 > 0:20:28always been little we can do.
0:20:28 > 0:20:32It feels quite proactive now that we're able to give TXA
0:20:32 > 0:20:35and potentially make a difference for this young lady.
0:20:35 > 0:20:38Charlotte's blood pressure is lower than Graham would like,
0:20:38 > 0:20:40but it's not getting any worse.
0:20:44 > 0:20:47She's minutes from specialist care now, but nearly half
0:20:47 > 0:20:51of patients who die in hospital do so through blood loss.
0:20:51 > 0:20:55Charlotte isn't out of the woods yet.
0:20:55 > 0:20:57Right, so this is Charlotte, 19-years-old.
0:20:57 > 0:21:00She's been found in a car stuck into a dry wall,
0:21:00 > 0:21:03crashed at an unknown period of time, God knows when she crashed.
0:21:03 > 0:21:06Just found unconscious in the car.
0:21:06 > 0:21:09That day Charlotte undergoes emergency surgery
0:21:09 > 0:21:13on her broken pelvis. She needs a blood transfusion
0:21:13 > 0:21:17and she's transferred to the LGI's high dependency nursing unit.
0:21:18 > 0:21:22She spends a week there before she's taken off the danger list
0:21:22 > 0:21:24and put onto a normal ward.
0:21:24 > 0:21:26She's been very lucky.
0:21:26 > 0:21:28Yeah, they thought I was going to die.
0:21:28 > 0:21:32So I had six bleeds in my head on my brain,
0:21:32 > 0:21:36and I had...I think it was four ribs broken.
0:21:36 > 0:21:39I've lost 70% movement in my left leg,
0:21:39 > 0:21:44I've broken my pelvis, and I've ruptured my spleen,
0:21:44 > 0:21:48so...and I've got a fracture at the back of my pelvis as well.
0:21:50 > 0:21:52So, it's pretty bad to be honest.
0:21:52 > 0:21:54It's not ideal.
0:21:54 > 0:21:58I probably wouldn't have made it if I went by road
0:21:58 > 0:22:00because my injuries are quite big.
0:22:02 > 0:22:05They obviously did a cracking job and I can't thank them enough.
0:22:06 > 0:22:09Thanks to a treatment pioneered 4,000 miles away,
0:22:09 > 0:22:14Charlotte has now returned home to the peaceful Yorkshire Dales.
0:22:14 > 0:22:19The first of many patients to benefit from lessons learned in a war zone.
0:22:26 > 0:22:30Now, the case of the wounded Army veteran who found himself in A&E
0:22:30 > 0:22:35again, less than five years after he survived an IED blast in Iraq.
0:22:38 > 0:22:41Radar Helimed nine-nine-alpha, slowing down for the LGI, we'll call again.
0:22:41 > 0:22:46Truck driver Paul Davey has been crushed between a lorry and a crane.
0:22:46 > 0:22:49Dr Tim Moll is concerned.
0:22:49 > 0:22:52It's likely that the impact has shattered Paul's pelvis.
0:22:52 > 0:22:55He may have major internal injuries.
0:22:57 > 0:23:01Emergency medics are trained to look around accident scenes
0:23:01 > 0:23:03for indicators of the forces involved,
0:23:03 > 0:23:08but today there was no missing the scale of the potential damage.
0:23:08 > 0:23:11His airway has always been OK, his breathing seems OK
0:23:11 > 0:23:13although he's got abrasions on it.
0:23:13 > 0:23:15CLATTERING
0:23:15 > 0:23:18..normal, not complaining of any chest pain.
0:23:18 > 0:23:19He's got abdominal tenderness,
0:23:19 > 0:23:22extreme pelvic tenderness over his pelvis.
0:23:22 > 0:23:25As soon as I saw the bent metal on the lorry, I was thinking,
0:23:25 > 0:23:30"This looks serious, we need to be in hospital as soon as possible."
0:23:30 > 0:23:32Luckily, all of his observations are stable, which is good.
0:23:32 > 0:23:35Obviously we're very suspicious about having a pelvic injury so
0:23:35 > 0:23:38he's going to go to the CT scanner as soon as possible, just to try and
0:23:38 > 0:23:41find out if there's anything going on inside his abdomen or his pelvis.
0:23:41 > 0:23:43Over the next few hours,
0:23:43 > 0:23:47surgeons battle to reconstruct Paul's pelvis.
0:23:47 > 0:23:51Though his injuries are severe, fortunately he has youth
0:23:51 > 0:23:52and fitness on his side.
0:23:52 > 0:23:55Two weeks on, and he's well enough to accept visitors.
0:23:55 > 0:23:58- Are you all right, kid? - I'm all right.
0:23:58 > 0:24:01For his parents, it's the second time they've
0:24:01 > 0:24:05had to see their son's life hanging in the balance, but he's getting
0:24:05 > 0:24:09better and memories of the horrific accident are starting to return.
0:24:09 > 0:24:12During, you know, it actually happening,
0:24:12 > 0:24:14I heard it break at least six or seven times.
0:24:17 > 0:24:21Every single one of them - crunch, snap.
0:24:21 > 0:24:24It just hurt more than the next.
0:24:24 > 0:24:27Surgeons have constructed a temporary metal framework to
0:24:27 > 0:24:29reinforce Paul's shattered pelvis.
0:24:29 > 0:24:34I think it's amazing what they can do with some bolts and washers.
0:24:34 > 0:24:39It's designed to keep my pelvis stable just temporarily
0:24:39 > 0:24:43until, you know, they can open me up and fix me properly,
0:24:43 > 0:24:49and plate up my pelvis and make it sturdy and strong again.
0:24:49 > 0:24:54And after that, I believe it's recovery, physiotherapy,
0:24:54 > 0:24:57hopefully, you know, then I'll be in a wheelchair
0:24:57 > 0:25:00and I'll be able to have a little bit more freedom of movement.
0:25:00 > 0:25:04For Paul, it'll be a long road to recovery, but he remains upbeat.
0:25:04 > 0:25:08He's now escaped death twice by the narrowest of margins.
0:25:08 > 0:25:12Once in Morley and once in Basra, Iraq.
0:25:12 > 0:25:17My best friend who was driving, it killed him,
0:25:17 > 0:25:20took my platoon commander's right arm
0:25:20 > 0:25:23and the wrist down, it took that.
0:25:23 > 0:25:27I've got a little angel on my shoulder, I must have.
0:25:27 > 0:25:30I don't now how many lives I've got but I must be running short now!
0:25:32 > 0:25:35Only a month after being crushed between the two trucks,
0:25:35 > 0:25:37Paul is back home.
0:25:37 > 0:25:41For his family, the accident brought the memories flooding back.
0:25:41 > 0:25:45It was like flashbacks from Iraq really. Erm...
0:25:46 > 0:25:48Oh, my God, what's he done now?!
0:25:48 > 0:25:51Panic sets in basically.
0:25:51 > 0:25:54But erm... Oh, yeah, er...
0:25:55 > 0:25:56..nerve-racking,
0:25:56 > 0:25:58very frightening.
0:26:00 > 0:26:03Thinking that...how could this happen to the same person twice,
0:26:03 > 0:26:06sort of thing, in such a short space of time, you know,
0:26:06 > 0:26:08something so life-threatening.
0:26:08 > 0:26:11Paul will start his physiotherapy soon
0:26:11 > 0:26:14but he knows better than most the scale of the challenge
0:26:14 > 0:26:17which lies ahead of him, both physically and mentally.
0:26:17 > 0:26:21The worst part about Iraq was, I would have to say,
0:26:21 > 0:26:23the post-traumatic stress.
0:26:23 > 0:26:26I had counselling for that for a long time.
0:26:26 > 0:26:29That were a long physio road as well, I did rehab course after
0:26:29 > 0:26:32rehab course for my legs with the physiotherapy,
0:26:32 > 0:26:33erm...
0:26:33 > 0:26:38but if I had to say which one was worst, I would say this.
0:26:38 > 0:26:42His dad sprang into action, modifying their house in just days
0:26:42 > 0:26:45so Paul could make an early return from hospital.
0:26:45 > 0:26:48As well as looking after Paul, the family are also organising
0:26:48 > 0:26:52a fundraising day in their hometown for the Yorkshire air ambulance.
0:26:52 > 0:26:55This family is not short on determination.
0:26:55 > 0:26:56He's very strong-willed.
0:26:59 > 0:27:01If somebody says he can't, he will,
0:27:01 > 0:27:05because that's what he's like, like myself, I'm exactly the same.
0:27:05 > 0:27:06He takes after me for that.
0:27:06 > 0:27:11If someone says you can't do that, well, we'll see, and he's the same.
0:27:11 > 0:27:15I'm pretty much sure he'll get over this exactly the same way.
0:27:15 > 0:27:19And I'm pleased to say Paul is hoping to return to work soon.
0:27:19 > 0:27:22And thanks to the generosity of his friends and family,
0:27:22 > 0:27:25the air ambulance charity has already received far more money
0:27:25 > 0:27:28in donations than it spent flying him to hospital.