Episode 14 Helicopter Heroes

If you're critically ill or seriously injured, seconds count,

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

-OPERATOR: 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.

-Still good on the left?

-Just behind you, Tim.

And every day the Helimed team's skill,

speed and courage is saving lives.

Today, on Helicopter Heroes...

Two trucks crash, and explosive gas bottles are leaking,

but moving this patient could kill him.

He's got a partially amputated right lower leg.

Exploring a shipwreck leaves a diver seriously ill.

Air rescue on scene on the beach, over.

On the highest hill in the Peak District,

a student's at the centre of a difficult rescue.

I've fallen then twisted my back a bit.

And the farmer who drove to his GP with a fractured skull.

Was it your bull then that thumped you?

We all expect the emergency services

to take risks to save the lives of others,

and those of us who have put on a uniform

are only too aware that's the case.

But sometimes extreme courage is called for

in the most unlikely places.

The ambulance crews based in the market town of Settle

cover one of the most remote areas of the Yorkshire Dales.

Their patch includes thousands of square miles of fell and moor

stretching to the borders of the Lake District.

Today, they have been called to the only major road

running through the area - the A65.

And Helimed 99 is on its way to join them.

A65. Yeah, lots of accidents, lots of motorcyclists.

As well as being a scenic route, it's a very dangerous route, as well.

Two lorries have crashed head on. One was carrying gas cylinders.

Its contents are strewn across the road and leaking.

One of the lorries is carrying propane, and the propane is leaking.

-Nice.

-And they've requested two helicopters.

Pilot Steve approaches with extreme care.

One of the critically injured drivers had been delivering oxygen

to the local ambulance station.

This one's the most serious driver, he's a big lad.

He's just delivered to us at Settle.

Ten minutes ago, they were drinking tea with him.

Now the local paramedics are fighting for driver Ian Rooke's life.

How are we doing?

We have Ian, a 45-year-old gentleman,

the driver of the BOC wagon.

From what I can gather, he's been ejected through the windscreen.

We've only just started, we had to drag him away.

He's obviously just delivered an oxygen supply to us, Entonox.

We'd just been chatting to him as he'd been doing his delivery,

then two minutes later got this accident with the wagons head-on.

When we got on scene, all the gases were going off

and we made a quick decision, rightly or wrongly, to put him

on one of our sheets and drag him away so we could deal with him.

It was risky for him,

but if the lorry blows it will have saved his life.

Airway's OK, tried to get a collar,

his neck's too big for a collar.

Firefighters are trying to cool the leaking cylinders.

Many have lost the valves sealing in their contents.

An explosive cloud is blowing in the wind.

We've got a male been ejected from his vehicle,

partially amputated right leg, fractured left leg.

Having a little trouble actually getting him

packaged at this stage, he's about 20 stone.

These paramedics have been assigned to care for the second trucker.

Pilot Steve knows the warning about explosive gas

may not have reached the second helicopter.

He's hoping to marshal it away from the danger zone.

We might as well do it. If we're going to reposition him,

we might as well do it when we've reached combi, haven't we?

No matter how experienced paramedics are,

few are immune from the stress that comes from dealing

with a patient they know.

Though they're not showing it, emotion will come later.

Injury-wise he has been KO'd,

he has multiple abrasions and lacerations to his body,

but he's got a partially amputated right lower leg.

We're querying a left femur,

and obviously we can't rule out a pelvis.

You can't go past that whatsoever.

We've got to go in that field, that's where the aircraft is.

At last, firefighters have had enough.

They've found highly-explosive acetylene cylinders

in the back of the truck.

One is enough to demolish a building.

Together, they're capable of sparking a disaster.

The medical team must retreat now.

FOGHORN BLARES

The North Sea is a dangerous place.

It's estimated more than 5,000 ships have been

wrecked off the Yorkshire coast alone,

and some of those long lost vessels are still claiming casualties today.

Scarborough - the largest resort on the Yorkshire coast.

This place attracts holidaymakers from across the country,

and here, in the once bustling fishing harbour,

a new industry is growing.

Offshore diving is an increasing part of Scarborough's economy.

Watch the back.

There you go.

Divers are drawn to this part of the coast

because of the shipwrecks, which lie beneath the North Sea waves.

But exploring the deep can put huge pressures on the human body.

And today the Helimed team is racing to the coast

to help a diver in deep trouble.

'22-year-old male with the bends

'going to the hyperbaric unit.

'EMA is currently waiting for the patient to arrive

'on the pier at Scarborough front.'

The diver's friends have called 999 as they think

he might be developing the bends, or decompression sickness -

a potentially lethal condition where nitrogen bubbles

build up in the bloodstream and joints.

As divers themselves, it's a condition paramedics James

and Sam are both very aware of.

I've never come across a patient who's had the bends before,

but, like James, I'm quite a keen diver in my spare time,

so I know a little bit about the theory behind it.

There are potential problems post-diving with flight,

but that tends to be if you're in a pressurised cabin.

Because this aircraft doesn't have a pressurised cabin

and we're not going to be flying at any great altitude,

we should be fine.

'Coastguard and crew are landing on the beach.'

It would be a hot load, wouldn't it?

Yeah.

Landing on the beach leaves the helicopter

in a vulnerable situation.

I can see an ambulance there.

Nothing exciting on the beach,

just some people down at the sea on the far right-hand side.

Are they securing the beach there, see the coastguard coming out?

-Two guys there.

-Two people, yeah.

-I get the feeling that's where they want us to...

-Yeah.

What I'm going to do, because there's a bit of a crosswind,

I'll come down the beach,

-rather than come too low over the sand.

-Yeah, OK.

If they shut down here and the engines won't restart,

Helimed 98 could be swamped by the incoming tide.

And clear out.

Air desk, on scene, on the beach, over.

So, to be safe, pilot Mark Griffiths

will keep the rotor blades turning while Sam examines his patient.

He's actually very stable. He has got right shoulder pain.

He's had mild headaches, but that seems to have eased off.

He's quite talkative and he is walking at the moment,

we put him on more oxygen just to keep it going.

-Have you been diving today?

-Yeah.

And you think you've ascended too fast?

No, perfect ascent, perfect.

17-year-old Adam Naylor has just been diving

more than 40 metres below the surface.

At the moment is it just

-a bit of pain in your left shoulder?

-Right.

-Your right shoulder, sorry.

He knows the pain in his shoulder could be a sign of the bends.

-You've not had any pain anywhere else, have you?

-No.

Just in your shoulder and a bit of pins and needles on the oxygen.

This rescue has become a bit of a seaside attraction,

but the paramedics know they can't hang around.

He is walking, mate, so we're just going to walk him across.

Do you need anything else?

No, he doesn't even need any pain relief, mate.

Did you get the Royal Navy doctor thing?

I heard something about keeping below 1,000 feet,

but that's pretty common sense.

I'll take him in, if you stay outside of this.

Although he looks OK, diver Sam knows that the bends could

still be developing inside Adam's body well after the dive.

If so, only specialist treatment in a decompression chamber

40 miles away can prevent it causing disability, or even death.

The Derbyshire Peak District is Britain's oldest national park,

and is reckoned to be the second most popular in the world,

with a staggering 22 million visitors a year.

But some of those visits end in an emergency.

High hills and low clouds have always been

a deadly combination for airmen, but when someone needs help,

the Helimed team does its best to reach them.

Today's mission couldn't be to a more difficult place -

the highest hill in the Peak District.

-I think it might be off in that cloud, you know.

-Do you think?

I'm wholly convinced. We've got another mile to go

and there's a big blanket of cloud where we want to go.

Somewhere on the 2,000 foot high slopes of Kinder Scout,

a teenager with a minor injury is in a very serious situation.

Mountain Rescue have got in touch

because the distance for them to get up the hills

would take them quite a considerable amount of time.

The weather around us isn't particularly amazing at the moment,

so exposure to the environment is their main concern

for the patient at the moment.

Let's just follow this path and see if we come across anyone.

-We could land and go along the top and go down somewhere.

-Yeah.

On a clear day, Kinder stands out as the biggest single peak

in a national park of 550 square miles,

an area bigger than Greater London.

Paramedics Leon and Graham face a scramble down to find

the casualty in an empty landscape.

99 Air desk, Have you got the number for the Mountain Rescue, Dave?

16-year-old Beth Harrison was scaling Kinder with a college party

when she slipped and injured her back.

Essentially, there was 36 of us up there, all climbing,

just on our way back down.

But she just took a little bit of a slip and jarred her back.

But she's OK, she's smiling away.

Members of the Edale Mountain Rescue Team have been keeping her warm,

and one of their volunteer paramedics has been giving Beth pain relief.

We've given her some gas and air, Entonox, for the pain.

Its common name is laughing gas, as you can see.

It's really good for pain.

It has got it down to zero, which is what we like.

I slipped, then I cut myself on my stick, and what I've done is just

fallen and then twisted my back a bit,

and it's just been really painful.

Kinder is a popular walking route, but it's not for the fainthearted.

Its paths are slippery, and a fall can be fatal.

Getting Beth up the peak to safety will not be easy.

We've rigged a back rope up to three chaps at the top,

who'll be holding it, so that as we carry the stretcher up

we know we have a final point of security.

Should anybody slip or anything we have the rope there to keep the stretcher secure.

At last, the long climb to the top can begin.

Go up a bit, then we'll go across to the rope

then straight up to Andy up there, OK?

You all right?

-SHE LAUGHS

-I'm glad she's having fun!

OK, let's have it right up.

We'll have it right up as far as we can.

I'm going up the path, it's too steep for me.

At the top of Kinder, most would be out of breath,

but Mountain Rescue train for this.

Put yourself back as best you can.

Beth's journey in the Helimed 99 is going to be short -

a short flight down into the valley below, where a land ambulance waits.

-Down here, I take it?

-Down here to the left, mate.

The patient, I believe, is going to make her way off to Chesterfield

Calow Hospital by the land crew, and we're going to head back to base.

The student's day in hospital was short.

Beth was so keen to get her walking boots back on,

she returned to her college course the next day.

Back to the scene of that serious crash in North Yorkshire now,

and fears are growing that an explosion

could cause further casualties.

Lorry driver Ian Rooke was dragged clear of his truck

by two local paramedics who, ten minutes before the crash,

were drinking tea with him at their ambulance station.

The Fire Brigade have discovered the load -

initially thought to be just medical oxygen -

also includes propane and acetylene.

Some of the necks appear to have been damaged,

so there's the potential for those to suddenly go off,

and there could obviously be fatal consequences from that.

The sound of escaping gas is very evident to all the emergency crews.

The high-pressure cylinders it's leaking from could easily ignite,

and Helimed 99 is in the danger zone.

Pilot Steve Cobb, must move his helicopter away,

into a safer position.

-We're going to have to reposition our aircraft.

-Yeah, you don't go back there.

So I'm going to ask the pilot to put it down out of the road here.

Could somebody stand and make sure nothing comes beyond your police car?

The hiss of escaping gas is now almost drowning out

Helimed 99's engines. Fears of an explosion are growing.

Is that pain easing?

Gas from the truck is making local paramedic Emma Carr feel woozy

but it won't prevent her trying to reassure her patient.

-We'll give you some morphine relief, all right? I know.

-MOANING

A tourniquet has been put around their patient's

partially-severed leg but he is still losing dangerous amounts of blood.

If his blood pressure continues to drop he could die.

If you want to grab the sides just so we support it.

Do you want to take it up a little bit or are you all right to keep it down?

Are you happy to support it? Are you happy to move?

The fire brigade advised the paramedics not to walk past

where the cylinders were which was the only access to the helicopter,

so we've moved the helicopter from where it was

in this field to one further down the road

so they can access it quite easily without passing anything dangerous.

The paramedics have a new weapon to help them reduce severe bleeding.

The drug TXA will help seal the leaking blood vessels

in their patient's leg by encouraging his blood to clot faster.

He's got potentially life threatening injuries.

He has been unconscious as well

so it's possible we've got a head injury.

He's got fluids. Dressed the wounds as best we can.

We've given him some TXA which is a new drug

we carry to help with extensive bleeding.

We'll get him off to LGI

and hopefully he'll be in the best place for the right treatment.

Just grab the feet and give a bit of support.

With their patient's leg patched up as best they can,

the paramedics now need manpower.

Ian's weight will also make the task of caring for him

in the cramped cabin of Helimed 99 even harder.

Try and keep the weight off as far as we can into aircraft or it's going to be difficult.

Keep coming, come on, keep coming.

The mental and physical effort involved at a crash scene

like this is immense but there's no respite.

I'm going to squeeze on your arm. All right, boss, we're off.

We'll get you to hospital shortly.

-Cheers.

-Let us know how he got on.

-Yeah.

-Cheers, Paul. Cheers, Tone.

-How much morph has he had?

-He's had 20.

Ian's heart is working hard, and struggling to pump a diminished

supply of blood around his badly-injured body.

The team knows he's likely to lose his leg, but his life is

also in the balance.

An accident on the bed of the North Sea has left

a young diver seriously ill with the bends, a life-threatening condition

that requires very specialist treatment here on shore.

Now lifted survivor, en route to Castle Hill.

Adam Naylor's flight to hospital will be fast and low.

Are your shoulders still all right? It's not got any worse, not changed at all?

You've not got any new pains developing anywhere? Fantastic.

Bubbles of nitrogen are trapped inside Adam's body

and altitude could make them worse

so pilot Mark Griffiths is hugging the tops of the

Yorkshire Wolds. His patient's life could depend on his skill.

Just document that he's had 15 minutes at 900 feet.

I don't know if it will affect how long we have to stick him in the chamber for.

I've already done that. I'm going to document when we land,

so we've got the right timings cos it does affect the chamber time slightly.

He's on his way here - to one of just nine category one

hyperbaric centres in the UK - where specialists are already

getting this odd-looking equipment ready for Adam's arrival.

They know patients have died if not treated quickly for the bends,

which is why speed is now so critical.

Just to that side of the hospital?

Yeah just where you see the light at 12 o'clock.

That's the pad. It's a full concrete pad.

I went down to 42 metres, a 38-minute dive, then ascended.

When I got to the surface I started getting pains in my right bicep,

so I told the people I was diving with.

They put me onto oxygen and got me here basically.

This young man has been out diving today. He said he's dived as normal.

Normal ascent.

When he's got back to the surface he's complained of pain in his right shoulder

which hasn't eased off after a few minutes

so he's told the medic on the dive boat and they're querying the bends.

He's quite well with it really,

but as a precaution they're taking him down to the hyperbaric

treatment centre where they'll give him oxygen under pressure.

Obviously the body's reacting to coming up from a rapid ascent

so anything could happen in the next 24 hours.

It's imperative we get him over to the hyperbaric treatment centre.

Treating decompression sickness isn't a quick process.

We'll just pop your neck seal on.

Adam's already had three sessions in here. Today he's back

for another two hours in this specialist pressurised room.

Just pop your oxygen tube in.

-Then we'll turn your oxygen on.

-Right.

'On Saturday evening I was in for five hours.

'Then I've been in twice since.

-'Both for two hours.'

-How's that feeling?

Fine.

'It was a really deep pain, a very strong ache in my shoulder'

and as a diver you've been told that that's what you've got to

look out for.

It's joint pains and I had one in my shoulder joint.

During the dive he's built up a nitrogen or a bubble head

in his body. That's got trapped in tissues.

In Adam's case in his shoulder.

What we do here is the faster the diver gets to us

the better that repressuring them or recompressing them

will shrink those bubbles and allow the body to reabsorb those bubbles.

But the main thing which decides whether that works is time.

Adam was able to get from the water, onto the boat,

into an ambulance and airborne to this centre in under 45 minutes.

And that's what's meant he's set to make a full, and speedy recovery.

The faster you get to us the quicker we can treat you

and the more likely you are to have resolution of those symptoms.

The longer and the bigger the delay, be that hours, days, a week,

the harder it is for us to treat those symptoms.

So now, it'll just be a matter of weeks before Adam can get

back in his drysuit for another underwater trip -

undeterred by his episode with the bends.

'I've always been aware of it but I think I will be taking my time

'even more than I have been now I've been bitten by it.'

From our doorstep pints to the butter on our toast,

we owe a lot to these girls, but every year an unlucky few see

another side of the placid animals that graze in our fields.

Britain is home to 10 million cattle

and this is the bovine equivalent of the X Factor.

Farmers drive 100 miles to exhibit their prize animals

at Driffield Show in East Yorkshire.

Entrants are combed and washed, gelled and polished.

But the Helimed team knows at first hand how powerful these animals can be.

We believe a male has been trampled by a herd of cows.

We believe he's got back to his car. We don't know how.

But the RRV and ambulance crew are concerned about his condition

and that's why they've requested us.

When a cow is faced with a dog, it can bring on a primal reaction.

Suddenly these docile creatures can turn aggressive,

and they have the weight advantage.

All right, how are you doing?

-Good.

-Good.

-I don't know what they told you, but we've got diminished breath sounds.

-Trampled by cows.

-15 of them anyway.

-All right.

Daytripper Geoffrey Westgarth is lucky to be alive -

a cow can weigh over a tonne

and he has narrowly avoided being trampled to death by a whole herd.

-Are you all right?

-How are we doing?

-Has my colleague given you..?

-A little bit, yeah.

Right, this is Geoffrey.

He's been in a field with his dogs and his wife

and the cows have become quite interested.

He'd happened to get down towards the wall

when they decided they would attack him.

So he's been pushed over, kicked quite a few times

and stood on as well.

It is the remote nature of this area that draws in walkers

but now Geoffrey is nearly 30 miles from the nearest accident and emergency department

and the winding Dales roads are notoriously slow.

He was up against the wall so he's managed to get away from

the cows, but the trampling went on for about five, ten seconds.

It was enough to probably give him some chest injuries, rib injuries.

They were driven to here, about 20 minutes away

but he couldn't go on any further in the car

and they've called us.

It was attacking from that side.

There's a fair old bruising.

You've maybe not realised they got you so many times.

Does it hurt when I touch your stomach?

Try not to tense. Just relax back.

It does look like he's got significant trample injuries

on his chest and down his left hand side.

Geoffrey needs to be in hospital.

His body is covered with bruises

and he could have serious internal injuries.

We need to take him down to James Cook.

He'll need X-rays if he's done any damage to his lungs his ribs, his abdomen.

The areas where he's been trampled on.

The initial concern of the land crew was he's got a diminished air entry

down one side of his lung, so we're concerned at that.

The priority now is to get Geoffrey into hospital

but with the constantly-changing weather

and low clouds over the hills this may still be tricky.

I know it's supposed to be summer, but very changeable.

Showers coming through in squalls.

Certainly around here it can prove to be bumpy trying to get

out of here, but at least we'll have the wind behind us on the way there.

We have lifted from just the west side of Richmond and bound for James Cook.

He's examined and X-rayed but later released after

treatment in Middlesbrough's James Cook Hospital.

He knows he's been very lucky not to be seriously injured.

Back at Driffield Show,

the men and women who work with cattle are well aware

of the dangers of getting too close to a protective cow and her calf.

In the last five years in the UK, 23 farm workers were killed by cattle

and nearly 600 injured. One of them was Eileen Wilson.

I had a nasty accident last year with a Limousin cow.

She didn't like me trying to get her in the crush

and so she decided to knock me over

and went over the top of me.

Fortunately she missed me

but I ended up with a dislocated knee in the process.

I was off work for five months basically.

Not fun at all. It hurts when they step on you.

There's one well known risk in many fields - the bull.

Weighing in at over a tonne, few ramblers would go anywhere near one.

But farmers don't have any choice and neither do paramedics.

There are times when wearing a bright red flying suit is

an advantage. This isn't one of them.

It's just 24 hours since the team's first cattle attack of the year.

And paramedic Tony Wilkes has a familiar feeling.

I've just been requested to go up to Aysgarth, to the GP practice.

Apparently somebody's in there with a skull fracture

and apparently THEY'VE been trampled on by some cows as well, so,

quite a coincidence, then again, we are flying around North Yorkshire.

There's a lot of farms and countryside and a lot of cows.

They get up to mischief.

In the village of Aysgarth, famous for its mile-long waterfalls,

farmer Robert Ewbank needs help.

He's been going to feed the bull

and the bull's decided he wanted to come out of the gate

at the same time he was coming out,

so when he was walking out, the bull knocked him over

and I think the gates hit him and he went down on the floor unconscious.

Robert has been assessed by a local GP.

Tony knows that a doctor wouldn't have called in the air ambulance

unless this was a life-threatening injury.

He's diagnosed the fact that this person has got a fractured skull.

Obviously, there's a chance of an infection getting in there,

pressure within the break being a problem.

So, yes, it's obviously really a problem here,

so we need to get to hospital, get some X-rays done,

to see exactly what damage has been done

and then obviously he'll be treated from there.

Local paramedics have looked after Robert in the back of an ambulance

and it seems that his head has sustained serious damage.

I'm not entirely sure of the depth, but he's got quite a nasty,

what looks like something going in there and coming out here.

This rural doctors surgery is used to dealing with farming injuries,

but the doctor knows that this time the patient needs

the facilities only a large hospital can offer.

He doesn't know, but the bull probably pushed him against the gate and he's got a head injury,

came up here to the surgery to see if we can stitch him here,

but he's obviously got a query skull fracture,

because he's bleeding from his ear, so he'll have to go to James Cook

and James Cook, being as far away as it is

needs the air ambulance, because it will be quick to get there.

But as the team get Robert out of the ambulance, he starts to vomit.

We're going to get you back on some oxygen, Robert.

If you feel sick again, just let us know.

Even when you're on this board,

-we can just turn you over onto one side, OK?

-Yes, yes.

In combination with his head wound,

this could indicate rising pressure in his skull.

How do you feel? Do you feel that sickness has passed?

-Yes, not so bad at the minute.

-Not so bad at the minute. OK.

Will you be happy then

if we just sort of lay you flat to see how you go?

You just relax, let yourself come down.

He probably has got a skull fracture, I would think.

But he's conscious and should be fine once we get him there.

Get some scans, but he's in the right place there at James Cook.

They've got all the neurosurgery.

Right, your bull then...

INDISTINCT

-Because it looks a big beast, does it?

-Hmm, just...

In fact, Robert's bull weighs in at three quarters of a tonne.

Like most farmers, Robert is obviously made of tough stuff.

It seems he actually kept on working after the accident.

He just sort of carried on doing what he was doing, then came home

and said, "I've had a bit of an accident."

Well, we came to Aysgarth, just to the GP to get him checked out and...

the GPs called the ambulance.

He's been, er, pushed over by a bull into a fence

and we're querying that he's got a fractured skull.

It's all dressed at the moment.

From what we've been told, there's two wounds.

One anterior, one posterior

and they're querying whether there's a foreign object in there

that might have gone in through the gate.

But like I say, it's dressed up at the moment.

Did have a period of loss of consciousness when it first happened

for about ten minutes, but it wasn't witnessed.

Robert went to his local surgery,

believing it was an injury his GP could treat.

But the team knows a fracture like this is life-threatening.

Paramedic Tony will be carefully monitoring Robert's condition

throughout this flight.

'I've not seen the wound itself',

but there's a possibility there's a foreign object

actually impaled in this patient's skull,

which obviously is a concern.

If it's not that, it could just be skull fragments.

But he's obviously got a skull fracture,

so there's all those possibilities there.

There's bleeding to the brain,

raised pressure within the skull itself

and obviously infection getting in if it's an open fracture.

So we are concerned, but saying that, he's quite stable at the moment.

So hopefully he'll be fine with us until he gets to hospital,

gets his X-ray, so we can see exactly what damage is done.

He's flown to the James Cook Hospital in Middlesbrough,

where doctors will confirm that his skull is fractured.

The foreign object turns out to be a piece of bone

dislodged in the attack.

Later that day, he undergoes surgery.

But there are no hard feelings.

He blames himself for irritating his prize bull.

I was going to feed him

and something, something spooked him at the top of the shed.

So when I set off to milk, he hit the gate and that was it.

I came round, the next thing I knew, there was plenty of blood about

and the bull was missing and one thing or another got sorted out...

I came back home

and the wife said, "I think I'd better take you to the doctor."

As the saying is, you never trust a bull.

They're not violent in any way at all, no, just one of them things.

Back in Driffield, judging has started at the show.

And vet Keith Dalby is busy.

He believes that growing numbers of foreign breeds

grazing British fields are behind the increase in cattle attacks.

But it's ramblers with dogs who are most at risk.

The great problem, of course, is the cow has just had a calf.

Because she's very protective towards the calf.

The last thing you want to be showing her is a dog

because she will immediately take defensive action against the dog

in order to protect her calf.

Certainly, the last thing to do is to pick the dog up

because, quite clearly, the cow will then attack the dog in your arms

and will be attacking you.

But it doesn't have to be a dog that gets you into trouble.

High above the North York Moors, the Helimed team

is heading to help an injured rider.

She's been thrown off her horse

after it was scared by some nervous cows.

We were trotting up the road and there were cows at the hedge that we didn't see.

The horse was terrified, so...she just slid along the road head first.

The cows that spooked the horse had calves with them in the field.

So, we're just going to walk round now and jump over the gate here

and see what's going on.

But first,

a rural obstacle, which regularly confronts these paramedics.

Electric fences are a common but painful hazard.

It's not going to be a great way to come back,

it might be worth telling Pete just to be aware of it.

-Lisa's come off a horse. The silly cow, wasn't it?

-Yeah.

Spooked her horse. She's come off. She's got a laceration above her left eyebrow.

She's got a graze on her chin. She's got a painful right elbow.

Yeah.

She has also got a pain in her left knee.

-Hello, Lisa.

-You keep still.

Nice to meet you. I'm sorry it's like this.

We are just going to pop you onto... onto a board, basically,

I think these two have described what's been happening

and what we're doing for you.

So, the horse has been put away, has he, or she?

-Yeah, yeah, they've all gone home.

-Right, OK.

She's a bit dazed, but she's not lost consciousness or anything.

She's a bit banged up,

she's pretty bruised and sore-legged but we think she'll be fine.

And it doesn't look like she's got any major injuries.

I think it's just going to be a spinal board,

due to the mechanism of falling off the horse.

Luckily, she's not complaining of any significant injuries,

but obviously, the transfer to hospital is quite a long way,

so we're just going to get a stretcher out,

pop her on a spinal board and take her up to the aircraft.

It's relatively rare for horses to be intimidated by cows.

They're not often seen as a threat.

But when young calves are accompanied by protective mothers,

accidents can happen.

If you tell that guy there in blue,

it's his cows at the back of the hedge that did it.

Nice big deep breath. That's it. Just suck it like a drink.

The team's patient isn't a regular rider.

The fall's left Lisa in great pain.

How does that feel, Lisa?

Any pain there?

For her husband and son, it's a difficult thing to watch.

It'll be all right, it's just a precaution.

Is this your mum? Yeah?

We'll look after her. Has that put you off riding horses, then?

No, she says she wants to be back on again.

I've yet to meet someone that's put off riding horses.

I hadn't ridden in two years. This is the first time in two years.

She comes up a couple of times a year, if that.

We always take her out when she's here,

but she doesn't ride at home, so...

it's the only riding experience she's got, really.

All right, ready? Lift.

And it's an experience which, thanks to these cows,

has left her taking a ride in Helimed 98.

-You all right, Lisa?

-Yeah.

-Yeah?

We're just having a walk down to the aircraft, we're all right.

No loss of consciousness, no C-spine tenderness or vertical pain,

pain on the left kneecap.

She's got a BP of 147/65,

GCS of 15 and is quite stable at this moment in time, over.

Lisa is X-rayed on arrival in hospital.

It's found her injuries are relatively minor.

But the experience ruins the family holiday.

Not the first to be spoiled by an animal

that also does so much good for all of us.

The victims of some unexpected accidents down on the farm there,

and happily both our patients are now well on the road to recovery.

But the outlook for injured lorry driver Ian Rooke is less certain

after a terrible road accident in North Yorkshire.

'We're out of Settle and on to the LGI. We just passed Skipton.'

Ian was lucky to survive a head-on crash with another truck,

and the explosive gas cloud

released by his cargo of pressurised cylinders.

'When we get him onto the thing, we'll just have a quick look,

'and I'll have a quick look at that tourniquet as well.'

If his blood pressure drops much further,

the team may not be able to save him.

Keep your arm there!

By road, the journey would take over an hour.

Helimed 99 is touching down at the Leeds General Infirmary

within 15 minutes.

Can we have plenty of hands round here if we can, please?

Cos he's quite a large chap.

Right, this is Ian. 45-year-old gentleman driving an artic lorry.

Head on with another artic, ejected through the front windscreen.

Were the Fire Service first on the scene?

Paramedics stopped Ian bleeding to death by giving him

a new drug, which they've only just started to carry.

TXA speeds up the clotting process

and was developed with the help of military medics

working in war zones.

They'll look at what the circulation is like to the leg below

and make decisions then, once it's cleaned up and straightened out

with the fractures, as to what the course of action will be.

So that could range from, you know,

long-standing operations and surgery

to amputation of that leg.

After his initial assessment by the surgeons,

the lorry driver is put into an induced coma

to let his body recover before surgery.

Back at Settle Ambulance Station, the medics who first treated Ian

have time to reflect on the most difficult and dangerous case

any of them has dealt with.

You obviously hope it won't be him,

and it won't be as bad as what you're getting on your screen,

but obviously it was when we got there.

Ian, I'm right by your head.

I was constantly talking to him and hopefully reassuring him,

explaining everything that was going on

and sort of trying to make light of the situation by saying,

"Oh, you know, we've just seen you," you know.

It was quite frightening.

When you can hear all the gas bottles hissing away,

you do feel a sense of danger there.

Me and Paul were starting to feel very woozy and headachy,

so it was definitely having an effect.

That's another reason why we needed to get out of there,

cos we didn't know what effect that would have on us.

It did sort of make the decision easier to move him rather quickly.

Ian spends three weeks in intensive care.

The paramedics in Settle saved his life.

But he loses his leg.

I've had my leg amputated just below the...

the knee.

All my centre of gravity has changed.

Where my leg came off, that was two and a half stone...

..which I thought was amazing, myself.

It's a month after the accident that nearly killed him,

and Ian has only hazy memories of what happened that day.

It was a blur. One minute you're delivering the gas to him

and having a laugh with him,

saying, "Morning, there's your gas."

And, next minute they're...

putting bandages on you and saving your life. It's...

..a funny old world, isn't it?

Few paramedics get to catch up

on the progress of the patients they treat.

But this was no ordinary incident.

And today, visiting time brings an unexpected reunion.

-Hello.

-Hiya.

-Ian? I'm Emma, Ian.

-All right?

-Nice to meet you.

-This is Tony and this is Paul.

-Hello, Ian, nice to meet you.

All right?

And for Ian, it's the perfect opportunity to say thank you.

I can't thank them enough for what they've done.

You know, if they weren't there, I wouldn't be here, so...

..it's good to see them and thank them personally.

And I'm pleased to tell you

Ian's learning to adapt to life with his disability.

He knows the outcome of his accident could have been even more serious.

Subtitles by Red Bee Media Ltd