Episode 13 Helicopter Heroes

If you are critically or seriously injured, seconds count.

And in Britain's biggest county, you can be a long way from help.

-Where's the patient?

-Stuck under the car!

The Yorkshire air ambulance flies at 150mph,

and thanks to its speed, hundreds of patients are alive today,

saved by a highly skilled team of doctors and paramedics.

-Stand clear, everybody.

-Keep going, mate.

It covers some of the UK's most rugged landscapes -

turning roadsides into operating theatres.

We're going to pop him off to sleep with an emergency anaesthetic, OK?

-And town centres into helipads.

-Just behind you, Tim.

And every day the Helimed team's skill,

speed and courage is saving lives.

Today, on Helicopter Heroes, a man has been crushed under

a giant crane, but the cause of some of his injuries is less obvious.

He just dropped to the floor like a sack of spuds, you know.

A teenage driver gets a new wonder drug from the front line of war.

If we give this it will cause clots to form and arrest that bleeding.

And an industrial accident leaves a worker blind.

Can his sight be saved?

He can't see at all, it's just black.

Working in the skies is a dangerous job

and the Helimed team isn't alone up here.

The cranes that dominate our cityscapes are vital

for construction companies.

But working with them has its risks.

And today, Helimed 99 is heading for the market town of Morley,

just outside Leeds.

On our right, three o'clock.

26-year-old Paul Davey was preparing a mobile crane when he was trapped.

The ambulance service's hazardous area response team was on the scene

within minutes, and Paul is already receiving medical treatment.

One male trapped between two wagons. Rolled back...

Paul has been crushed between a lorry and a crane.

Workmates heard him screaming, ran to his aid

and managed to separate the two vehicles.

He was screaming, yeah. I just panicked.

I was looking for the brake but I couldn't find it.

So I've just come round to the vehicle and reversed it back.

Just to let him free of it, really.

He were in pain, you could tell he were hurt, like.

Air ambulance doctor, Tim Moll

and paramedic Dave Appleby must assess their patient quickly.

It's likely that he has severe internal injuries.

-From the mechanism in his pelvis, he's got a bruise over his pelvis as well.

-Right.

-We'll get him out and have a look at him.

-Can I just sneak through, chaps?

As Paul was pinned between the two vehicles,

part of the lorry's metal bodywork actually bent around his pelvis.

We'll get this out the way and get the T-Pod on...

Understandably, Paul is in a lot of pain,

but something is puzzling Dr Tim.

Paul has obviously been in a major accident at some point in the past.

Listen, you have to breathe deeply or it won't work.

That's it, nice, slow deep breaths.

The team is worried.

Paul could be bleeding internally.

And with crush injuries like this, it could kill him.

He's not had the handbrake on in the cab and it's rolled forward

and crushed him against the crane at the side.

I was at the back of the trailer with Daniel

and it all went bad really and crushed him.

Workmates leapt to Paul's aid.

They managed to separate the two vehicles but it was too late.

The damage had been done.

I've come round and reversed the vehicle

and he just dropped to the floor like a sack of spuds, really.

This lad here has helped him to get out of the way of the vehicle.

Dr Tim Moll gives Paul a dose of ketamine.

This is a very strong painkiller which works by interrupting

the pain signals travelling to the brain.

Paul, open your eyes.

All right, Paul. Relax. Relax.

Paul desperately needs life-saving surgery in hospital,

but first, the team must make sure he is fit to fly

and that means stabilising his shattered pelvis.

There may be few beneficiaries of war

but medical science is one of them.

Millions of civilian patients benefit from lessons learned

on the front line.

And the Helimed team uses several life-saving techniques

pioneered in recent conflicts.

The war in Afghanistan is never far from the minds of thousands

of families in North Yorkshire.

Most recruits do their basic training here

and Catterick is the British Army's biggest garrison.

But today, some of the lessons learned by the military

in the faraway province of Helmand in Afghanistan,

are about to come home in an unusual way.

Helimed 98 has been scrambled to a crash in the Dales.

-That is where we are going then.

-Yeah, no problem. OK, can you take us, please?

They've got a car that's rolled.

The female driver's trapped.

They've called me to say she has a low BP, low blood pressure.

Obviously, she could be bleeding internally.

-Your bearing is 265, please.

-Sure.

Internal bleeding is a killer.

But air ambulance paramedic Graham Pemberton,

has a new weapon in his armoury.

A new drug. It is the opposite of the thrombolytics we used to give

to people who had a heart attack, which would stop the blood

from clotting and stop the heart attack from getting any worse.

We've now got a drug which does exactly the opposite

and encourages the blood to clot so it stops them bleeding out.

But the weather is against them.

The hilltops of the Dales are swathed in low cloud,

blocking the route to the crash scene.

OK, what about... No low ground left or right there. Where are we?

-The lowest is... We are here...

-OK, yes.

-We followed the road, but it is...

We could go straight back there, couldn't we?

-Helimed 98 receiving?

-98, go ahead, Dave.

I've spoken to the crew on scene, they said they can see the hilltops

from where they are, Graham, with about 5K visibility, over.

Roger, thanks, Dave. Visibility is not looking too bad now.

We've got a bit further on. We have an ETA now of six minutes. Over.

Roger, thank you.

The weather at the accident scene may be good

but they are having to take a long diversion over lower ground.

Should be on the nose, a mile.

A visual with something there on the left?

-Yes, visual at the scene, yes.

-Yes, we've got it.

But at last, they have made it.

Their patient has been freed from her wrecked car,

but her blood pressure is still worryingly low.

-Is it hurting down here?

-Charlotte Atkinson is 19.

She is a carer who was on her way to look after an elderly lady near

the village of Austwick when her car crashed into a dry stone wall.

She's in quite a lot of pain in her pelvic area.

And Graham's just assessing her, whether we are going to give

her TXA and we're going to package her and take her.

Hiya, my name's Graham, I'm a paramedic on Helimed 98.

I've got a 19-year-old female.

She has hit a dry stone wall

and it looks like some of the stones have come through the car.

She was found by a passer-by unconscious.

Her initial obs were she was tachycardic with a blood pressure of 95/55.

Graham calls doctors at Leeds General Infirmary.

TXA or Tranaxemic Acid, will help Charlotte's blood clot more easily,

helping close the vessels that are leaking into her abdomen.

But I'm just wondering whether or not to give her some TXA anyway,

because we've got a 17 minute flight in

and we have yet to get her into the helicopter.

An off-duty policeman and a member of the public stopped to help her.

They gave some good help and they got a good location for us

-to attend very quickly.

-Your lower back hurts?

We were fortunate enough to be able to get the air ambulance,

given the cloud cover. We were lucky.

And she'll be going to a good trauma unit at LGI.

Graham knows that even with the team's new wonder drug,

Charlotte's life is in real danger.

It's terrifying to think how a freak accident can

result in the loss of your eyesight.

But there is a frightening number of ways that can happen.

Some of them so rare few doctors have experience of them.

We just had reports of an industrial incident down near Rotherham

in South Yorkshire. It's a bit vague at the moment.

Apparently, somebody may be trapped in some kind of machinery.

And they may have sustained a serious head injury, query,

they are unconscious at the moment. So...

Information is quite limited but on the information we've got,

it does sound like it could be potentially quite a serious incident.

The paramedics are regularly called to industrial accidents

and know that big warehouses often mean big machinery,

with the potential for big injuries.

We've got a car down near one o'clock now. A single car.

It's ideal to park there just on the hard standing there.

At this packaging warehouse,

employee Stephen Neesam has been crushed by machinery.

I'll shut this down because there's people on the scene.

Yeah, the crew is inside.

Just entering an environment like this to find a patient is dangerous.

The warehouse is filled with huge rolls of paper

and the heavy machinery used to move it around.

All that we got was that it was an industrial accident that, er,

a male had been crushed in some kind of machinery.

It's on some sort of lift that seems to have malfunctioned

or there's some fault with it.

Fortunately, land paramedics got to Stephen quickly and freed him.

His chest was crushed in the accident,

but strangely he's lost his vision in both eyes.

Can you manage to open your eyes then, Stephen?

Honestly, I don't know whether they're open or not, mate.

-I can't tell you. If I'm flickering them...am I flickering them?

-Yeah.

But I think my eyes are full of dried blood.

Are my eyes full of blood?

Basically a bit of machinery has come up and trapped this guy.

He's got a lot of bruising, and a lot of blood around his face.

The main concern at the minute is that, although his eyes

are open or partially open, he just can't see at all. It's just black.

So obviously we need to get that checked out.

So, the nearest hospital for us is Sheffield Northern,

which has got some services to look at people's eyes

so we'll take him with us and see what's occurring.

-Where is it hurting in your chest?

-It's just...it's here, mainly.

It's just like an ache.

The weight of the machine which crushed his chest

appears to have raised Stephen's blood pressure so much,

it's burst vessels in his eyes.

It's a rare but very serious condition.

Neither Daryl or Tony have seen this condition before,

but they can help.

Getting him to a specialist hospital as soon as possible

will give him the best chance of regaining his sight.

He's got quite significant facial injuries

and he's actually lost vision in both eyes.

We're bringing him in from Wath so flying time is approximately,

probably with you within the next 10 minutes or so.

Finally, a glimmer of hope.

Now he's out of the dark warehouse,

Stephen thinks he can detect some movement.

-Somebody's just climbed in.

-Yes. I have.

And somebody is stood by the door now, aren't they?

-Yep.

-Yes. I've just got your outline.

-Better than you were saying before.

-Yeah, and have you just climbed up?

-I have, mate.

-Yeah, yeah, I can see your silhouette.

You're moving your head about, your head's just above me.

All right, OK, still clear to your left. Stay on the right here, Tim.

OK, I'll just go straight up and turn my nose to the right.

Stephen has flown to Sheffield, where he's immediately

transferred to the eye department of the Hallamshire Hospital.

It's here surgeons carry out a very rare procedure to relieve

the pressure in his eyes and save his sight.

I was concerned of course but his vision was dropping,

and we know that in this kind of situation, you probably have

a window of about an hour to try

and relieve the pressure, to have a chance of restoring the sight.

You make a little cut in the lower lid on the outer side here

so that the lid basically flops and is not supported by anything,

and it just allows all the pressure to come forward.

These tomatoes aren't growing very well,

but never mind, I'm sure they'll come on.

Peapods for your mum.

And within a few days,

he's back home with his eyesight fully restored.

Yeah, they look like they're growing well as well.

He just cut down the side of my eyes with a pair of scissors

and instantly this one came...

When it came down, I could see around the room straightaway.

It was more or less instantaneous.

My sight came straight back

and I was amazed to see how many people there were in the room.

Sometimes they're a bit awkward because they're prickly...

'My daughter has got her prom night coming up. I wouldn't have seen her going to that...'

I wouldn't have seen her at her wedding.

I would've been there, but that mere thing,

it's such a big disability.

It was the speed of Helimed 99 and A&E staff that put

Stephen in the hands of an eye surgeon

within an hour of his accident.

Today Stephen is returning to the Hallamshire for a checkup.

-Hey!

-Hi!

-Hello, Stephen, nice to see you again.

-I suppose the comment would be it's good to see you again.

-Yeah.

And his surgeon has something to tell him

about the procedure that saved his sight.

That was the first time I'd ever done it as an emergency.

I think the fact the A&E consultant realised they needed

to call me early on, that it was me, that I had a good team here

helping me get things ready, I think they were all on our side.

So unusual was the operation,

40 hospital doctors crowded in to watch Dr Mawer at work,

and medical photographs were taken to be used in training.

Stephen's case was as rare as they come.

It's just basically getting the scissors in, and having to do

a little cut on the lower lid there to release all the pressure.

It's quite shocking, really, to see the actual state of my eyes.

I've seen some of the stills when I initially arrived at A&E,

but to see the cuts and the blood

coming out and the pressure, it's quite shocking really.

A major traumatic injury is something most of us

suffer at worst once-in-a-lifetime, but there's an unlucky few

who find themselves in A&E twice in a relatively short time

and that poses a problem for the paramedics trying to treat them.

In the town of Morley, just south of Leeds, Paul Davey, a worker

at a plant hire firm, has been crushed between a lorry and a crane.

Is the pain easing off a bit?

He's been working on a heavy goods vehicle,

which has rolled for whatever reason.

It's took him with it and looks to have given quite substantial

pelvis and lower leg injuries, as well as a fracture.

It's quite a range of injuries there that could prove

life-threatening so we need to get him to hospital, get him stabilised.

Once the ketamine kicks in,

hopefully we'll be able to manipulate them a little bit better.

We'll take this out and we're going to put our scoop on him, all right?

Yes? OK.

Moving Paul from this tight spot isn't going to be easy.

The team use a split stretcher called a scoop.

Former RAF officer Dave Appleby takes charge.

He knows the extent of Paul's internal injuries

will be revealed in hospital,

but he's still puzzled by the extensive scarring to his legs.

Paul is loaded onto a land ambulance for the short journey to the

chopper. Here it emerges that this isn't his first brush with death.

Do you have any medical problems at all that you see a doctor for?

Are you completely fit and well normally?

MUFFLED: I was blown up in a roadside bomb in Iraq in 2007.

-A bomb in Iraq in 2007?

-I was blown up in a roadside bombing.

Oh, you were in a roadside bombing? Military?

-Did you sustain any permanent injuries from that?

-Yeah.

-I've seen a scar on your knee.

-Ahh!

Paul was travelling in one of the Army's infamous

Snatch Land Rovers when his convoy was hit

by an improvised explosive device.

So he's fit and well normally. He was blown up in Iraq.

He was roadside bombed so he's not very lucky, is he?

Getting information about Paul's past injuries will be essential

for the surgical team in hospital, and it turns out

Paul's legs are still peppered with fragments of shrapnel.

We're just going to start putting you in the helicopter, OK?

Just watch that arm, Pete.

Today, ex-squaddie Paul will be travelling with former Army pilot

Chris Attrill.

The flight to the Leeds General Infirmary will take just minutes.

This is the second time Paul has been critically injured,

and this time his recovery is in real doubt.

Back in the Yorkshire Dales, injured motorist Charlotte Atkinson

is a long way from hospital, and the paramedics

caring for her are concerned that her condition may be getting worse.

Paramedic Graham Pemberton is banking on a new drug called TXA to

staunch the internal bleeding that is threatening his patient's life.

This is a tranexamic acid.

This actually causes blood to clot so, because her pressure is starting

to fall again and her heart rate is going back up, it suggests she's

actually still bleeding actively somewhere. So if we give her this,

it'll cause the clots to form and arrest the bleeding more effectively.

We put it into a fluid and then it's infused over 10 minutes.

Charlotte's seriously ill but now she's safely in the hands

of the Helimed team, the police have other priorities.

The traffic has managed to get round one of the local villages

so we've got a bit of a diversion on at the minute, so hopefully

we'll get it cleared before the real traffic starts this morning.

The A65 is a major holiday route to the Lake District,

and this is a bank holiday.

At last the road can be reopened.

OK, just go parallel with the road to our left.

Many wounded soldiers owe their lives to TXA

but this is the first time it's been used by the Helimed team.

It's come mainly from the military sort of thing, Afghanistan

and Iraq, where they've give them much more aggressively

and it was shown conclusively that giving this drug within

three hours of injury saves a large number of lives.

Graham fears Charlotte has smashed her pelvis.

Injuries like this can quickly lead to patients bleeding to death.

From experience, the patients that have an internal bleed,

it's quite frustrating for us as paramedics that there's

always been little we can do.

It feels quite proactive now that we're able to give TXA

and potentially make a difference for this young lady.

Charlotte's blood pressure is lower than Graham would like,

but it's not getting any worse.

She's minutes from specialist care now, but nearly half

of patients who die in hospital do so through blood loss.

Charlotte isn't out of the woods yet.

Right, so this is Charlotte, 19-years-old.

She's been found in a car stuck into a dry wall,

crashed at an unknown period of time, God knows when she crashed.

Just found unconscious in the car.

That day Charlotte undergoes emergency surgery

on her broken pelvis. She needs a blood transfusion

and she's transferred to the LGI's high dependency nursing unit.

She spends a week there before she's taken off the danger list

and put onto a normal ward.

She's been very lucky.

Yeah, they thought I was going to die.

So I had six bleeds in my head on my brain,

and I had...I think it was four ribs broken.

I've lost 70% movement in my left leg,

I've broken my pelvis, and I've ruptured my spleen,

so...and I've got a fracture at the back of my pelvis as well.

So, it's pretty bad to be honest.

It's not ideal.

I probably wouldn't have made it if I went by road

because my injuries are quite big.

They obviously did a cracking job and I can't thank them enough.

Thanks to a treatment pioneered 4,000 miles away,

Charlotte has now returned home to the peaceful Yorkshire Dales.

The first of many patients to benefit from lessons learned in a war zone.

Now, the case of the wounded Army veteran who found himself in A&E

again, less than five years after he survived an IED blast in Iraq.

Radar Helimed nine-nine-alpha, slowing down for the LGI, we'll call again.

Truck driver Paul Davey has been crushed between a lorry and a crane.

Dr Tim Moll is concerned.

It's likely that the impact has shattered Paul's pelvis.

He may have major internal injuries.

Emergency medics are trained to look around accident scenes

for indicators of the forces involved,

but today there was no missing the scale of the potential damage.

His airway has always been OK, his breathing seems OK

although he's got abrasions on it.

CLATTERING

..normal, not complaining of any chest pain.

He's got abdominal tenderness,

extreme pelvic tenderness over his pelvis.

As soon as I saw the bent metal on the lorry, I was thinking,

"This looks serious, we need to be in hospital as soon as possible."

Luckily, all of his observations are stable, which is good.

Obviously we're very suspicious about having a pelvic injury so

he's going to go to the CT scanner as soon as possible, just to try and

find out if there's anything going on inside his abdomen or his pelvis.

Over the next few hours,

surgeons battle to reconstruct Paul's pelvis.

Though his injuries are severe, fortunately he has youth

and fitness on his side.

Two weeks on, and he's well enough to accept visitors.

-Are you all right, kid?

-I'm all right.

For his parents, it's the second time they've

had to see their son's life hanging in the balance, but he's getting

better and memories of the horrific accident are starting to return.

During, you know, it actually happening,

I heard it break at least six or seven times.

Every single one of them - crunch, snap.

It just hurt more than the next.

Surgeons have constructed a temporary metal framework to

reinforce Paul's shattered pelvis.

I think it's amazing what they can do with some bolts and washers.

It's designed to keep my pelvis stable just temporarily

until, you know, they can open me up and fix me properly,

and plate up my pelvis and make it sturdy and strong again.

And after that, I believe it's recovery, physiotherapy,

hopefully, you know, then I'll be in a wheelchair

and I'll be able to have a little bit more freedom of movement.

For Paul, it'll be a long road to recovery, but he remains upbeat.

He's now escaped death twice by the narrowest of margins.

Once in Morley and once in Basra, Iraq.

My best friend who was driving, it killed him,

took my platoon commander's right arm

and the wrist down, it took that.

I've got a little angel on my shoulder, I must have.

I don't now how many lives I've got but I must be running short now!

Only a month after being crushed between the two trucks,

Paul is back home.

For his family, the accident brought the memories flooding back.

It was like flashbacks from Iraq really. Erm...

Oh, my God, what's he done now?!

Panic sets in basically.

But erm... Oh, yeah, er...

..nerve-racking,

very frightening.

Thinking that...how could this happen to the same person twice,

sort of thing, in such a short space of time, you know,

something so life-threatening.

Paul will start his physiotherapy soon

but he knows better than most the scale of the challenge

which lies ahead of him, both physically and mentally.

The worst part about Iraq was, I would have to say,

the post-traumatic stress.

I had counselling for that for a long time.

That were a long physio road as well, I did rehab course after

rehab course for my legs with the physiotherapy,

erm...

but if I had to say which one was worst, I would say this.

His dad sprang into action, modifying their house in just days

so Paul could make an early return from hospital.

As well as looking after Paul, the family are also organising

a fundraising day in their hometown for the Yorkshire air ambulance.

This family is not short on determination.

He's very strong-willed.

If somebody says he can't, he will,

because that's what he's like, like myself, I'm exactly the same.

He takes after me for that.

If someone says you can't do that, well, we'll see, and he's the same.

I'm pretty much sure he'll get over this exactly the same way.

And I'm pleased to say Paul is hoping to return to work soon.

And thanks to the generosity of his friends and family,

the air ambulance charity has already received far more money

in donations than it spent flying him to hospital.