Emergency Helicopter Medics: There’s a race to reach a man who has fallen 40 feet from a ladder.
Heli-medics race to a skydiver suffering serious injuries after smashing into a house. And there’s a race to reach a man who has fallen 40 feet from a ladder.
Britain’s busiest air ambulance teams race to bring the hospital emergency department to where it’s urgently needed
Emergency Helicopter Medics
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Emergency Helicopter Medics – Season 2024
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Hello Anglan. Highly skilled doctors, paramedics and pilots. Children race against the clock to save lives. We are now mobile incident. Unique teams difficult access. We’ll be inventive. Delivering specialist care. Probably going to be quite uploaded as well. From the roadside to the hospital. Are we going to be landing on the beach? These are their stories. You’ve been hit by a train. I’m here to look after you. So, this is the most alert he’s been by far. For me to be having that day where I’m doing everything that I’m trained to do means it’s someone’s darkest day. So, both lungs are off on ultrasound. You are not going to die. We’re obviously in the middle of nowhere out here. We get to make a difference in their lives. So, how many shocks have you had? I’ve lost the pulse. Every patient’s different. Every injury is different. And it’s constantly a challenge. Our patient’s still on the side of the ridge. He’s going to dangle me off the helicopter. It’s a bit windy for dangling. Are you looking after our doctor in the back? Good. It’s hugely rewarding to be able to provide support and care to patients at the time that they need it the most. Sorry about the inconvenience. Good inconvenience. This is what we do. T-side International Airport. From here, the Great North Air Ambulance deploys critical emergency care across the north of England. Flying from bases in Cumbria and here in T-side, are you fit to fly? Just on shift, pilot Stuart Rushton, paramedic Paul Bernage, and manning the comm’s desk, paramedic Ian Gray. Have you got a telephone number for somebody on scene? Did you see it? Today’s duty doctor is A andd consultant Dion Arid. My normal day job’s working as a consultant in the emergency department at one of the major trauma centers, but when I’m not there, I quite often work shifts on the air ambulance at the weekends. One of the reasons I like to do prehosp emergency medicine is it is so varied. You never know what you’re going to go to, and sometimes you can make a real difference to someone’s life. Did you say that desk 6953? Did you see? A parachutist has crashed into a house and is suspended above the ground. The crew scrambled. It’s a 28 mile flight northeast to Shot and Collier, an ex mining village in County Durham. They’ll be on scene in under 10 minutes. I’m suspecting the worst. If he’s hit the house at speed, he could have anything from broken bones to internal bleeding or even a severe head injury. The given is actually the parachute center. Uh that’s not where the house will be where he’s on. I’ll speak to him. I’ll be clear. Yeah, man. I bought that initial grade that I gave you. That residential uh house is 3 4 1 2. Roger. That’s a safe bit. She’ll be unseen. We get called to parachute centers a few times a year. Skydiving’s fairly low risk as action sports go. But when it does go wrong, it can be catastrophic. Okay. On the northwest side of that, I’ve got the buildings there, which I guess is the hangers. Yes. Right on the nose. It looks like he’s landed just outside the drop zone, mate. Look, we’ve got him down by now. There he is over there down the street. Two fire engines. I’ll have to come over the top back around to the right to land. Yeah, no worries. We can get out of there. There is a parachute on the roof. Yeah, I can see it. Good on the left. 63 that way down there. I’ve got the blood. The air ambulance started carrying fresh blood and plasma in 2015. Since then, prehosp transfusions have saved dozens of lives. Okay. With his parachute tangled in the TV aerial, the sky diver is dangling in his harness just a few feet from the ground. You don’t know much yet. He has got the open tim right side. I think he’s complaining the right arm as well. Confirm his conscious then. That’ll do. Right. If he’s talking, his airways clear. He’s able to breathe. So that’s a good thing. Has got a severe fracture to his lower leg, but we don’t know what other injuries he has. We’ll get him down. Have a look at him. Dion and Paul discuss an action plan with the fire and rescue incident commander. Tell you what we’ll do when we take his weight. We’ll get the stretcher underneath. Cut. So, he’s going to come straight down there. So, we’ll get our trolley cut underneath there. Yeah, no worries. In this situation, working with fire and rescue is extremely important. We’re all one cog in the machine. That’s going to save the patient’s life. They’ve already set up a rope system to take the patient’s weight. Land paramedic Alec has climbed up to have a closer look at his injuries. The patient could have multiple life-threatening injuries, but Dion can’t start an assessment until he’s down on the ground. Dread down on the trolley now. to me. To me, to me, to me further this way. Right. Arm. Your arm. Scissors. Someone’s got some shears. Your legs. Your arm. Thank you. Right. Hello, mate. What’s your name? I’m lucky. I think What is your name? Darren. Darren. Darren has been skydiving for a year and a half. This was his 15th jump. Darren. Yeah. You’re normally fitting well. Yeah. Okay. Ah, leg. Give me my right leg. Darren’s foot needs urgent treatment if it’s to be saved. It’s bleeding heavily and causing him a huge amount of pain. Before I give Darren any really strong painkillers that might make him drowsy, it’s important for me to identify all his injuries if possible. He may well have injuries inside that I can’t yet see. Darren, listen to us. Have you got any pain on your chest there on that side? No. Any pain in your tummy at all? No. Right. Is it sore when I’m touching there? My arm is ah not your arm. On your hip there. Is that sore? I can’t feel. Can you wiggle your left foot? Good man. Okay. Not me right. Not your right. No, that’s fine. Wiggle, right? This ain’t good. Right, Darren, listen to us. Okay. You’ve definitely broken your right ankle. You got any pain anywhere else? Elbow. Good man. Very sweaty, man. It’s going to be a pelvis. Paul, looking at the color of them. Yeah, if you break your pelvis, it can be very, very serious. He’s very pale and sweaty and from his mechanism of hitting the wall at high speed, he may well be bleeding inside his pelvis. You can lose your entire blood volume in a matter of minutes. Right. Sharp scratch in your left hand. Keep your arm still for you. All right, good lad. Once you’re secure, we’ll try and get this binder down. We’ll work from there. We need to apply a pelvic binder to keep the pelvis in place and stop the broken bones moving around. It can help to control the bleeding although it will not stop that hemorrhage completely. Can you put that a bit straight up there? Okay, great. Ch. Darren, you said you’re not allergic to anything, are you? Yes. Can I die for the sound of it? You’ll be back before you know it, Nick. Darren needs strong pain relief before they attempt to reposition his foot. Darren, listen to us. You probably won’t remember anything else until you’re at hospital. Okay. Yeah. Good man. What happened? Got your crosswind, your downwind, and your upwind mixed up, mate. All right. 30 cm, mate. Give him a bit of morphaz as well. Yeah. Paul is giving Darren a combination of ketamine, morphine, and midazzelam. Can somebody pull us up a gram of TXA, please? And TXA or transexamic acid, which promotes the clotting of blood. All right, Darren. He’s had kit. That’s more from my dad’s going. Bring some O2 to pop on him, and then we’ll have a good look at his legs. So those scissors still there. We swap ends. How we doing, Darren? Hope no one’s squeamish if you look away. Okay, Paul, let’s straighten his leg up first. Have you got it? I’m working on it. I’m working on it. The end of his tibia or his leg bone has broken. It’s what’s called an open fracture, which means the skin’s broken and the bone has effectively come out. Oh, dear me. What a mess. What a mess he’s made with that. The fracture that Darren’s got is really severe. I need to try and straighten his leg out as fast as possible to prevent further complications and maintain the blood flow to his foot. But no matter what I do, it’s still possible he might lose it. Sorry. Do you want to give him some more cash? Can you give him another 20? Once Darren’s pain meds are topped up, they’ll start to manipulate the broken bones. That’s 50 a kit in total. in total. Right. Then can you grab a sterile either small or large dispensal wells, please? Darren’s foot’s obviously quite nastly displaced. The bones are broken and way out of position. Don’t know if this is going to go reduced, but we’ll give it a go. Right, you got the top end. Hold that for us. Right. Some wet gauze and then a splinter, a box splint of some sort. back. Ideally, it’s fine. Just bandage. Dion and Paul stabilized the fracture using a vacuum splint. A vac splint is basically a bag full of little polyyrene beads which we can form around Darren’s leg. Okay. Can you vac? And then when we suck all the air out, it will go hard and form a cast and prevent the leg from moving. He’s got no radial there. Right, we’re 70 systolic. We’ve got no radial at the moment. Okay, Darren’s blood pressure has dropped and he’s lost his radial pulse. That’s very worrying cuz I think he might still be bleeding and then we’ll go. In County Durham, the crew of Helmed 63 have just straightened the badly broken foot of a skydiver who crashlanded into a house. The patient, Darren, also has abnormally low blood pressure, no radial pulse, and a very high heart rate, indicating that he’s losing blood fast. And let’s see what pressure is. It’s tacky about 110. 40% of trauma related deaths are caused by bleeding. The crew need to get Darren’s internal bleeding under control. Paul, can I have some FFP? Actually, right, Dion. Yeah. Is 187. Ready? Yeah. Because Darren’s still bleeding and his blood pressurees dropped, we now need to transfuse him with FFP or fresh frozen plasma, a blood product that comes from blood donors. The FFP will replace some of the blood volume which Darren has lost. It also contains vital clotting factors which should slow down the bleeding. O2 M. Let’s go. All right. We’re going to get you moving though. Can have some more cat. If Darren continues to bleed like this, it’s possible he could lose all his blood volume. Our priority is to get him onto the aircraft as quick as possible. He needs to be in the hospital. Everyone ready? Yeah. Okay. Ready, steady, lift. Got it. All right, Darren, you’re almost in, mate. Almost in. That’s it. We’re good there. Yeah. Okay, Stu. James Cooker, please. The team will fly Darren to the major trauma unit at the James Cook Hospital in Middlesborough. Okay. I’ve got a 50-year-old male parachutist who’s hit the side of a house. Yeah. And can you activate MHP, please? Mhm. No problem at all. We pre-alert the hospital and requests the major hemorrhage pack. That’s when the hospital gets blood products ready for our arrival. So, there’s no delay in transfusing the patient further. There’s the M&M actually running. Slowly uh carry pedal antipart flight only about 10 minutes but that can seem like a lifetime if the patient is very poorly or continues to bleed. Uh 9766. Yeah. 104. What was it before? It was 110. The numbers are going in the right direction. Throughout the flight we will monitor Darren’s blood pressure and his pulse rate. still with us here, isn’t it? Yeah. Yeah. Yeah. You can’t just sit back and relax. Things can change very, very quickly in trauma patients, particularly patients with multiple injuries. Hey, Darren, go for it. When we’re first called to jobs like this, we never know quite what we’re going to find when we get there. Darren’s unfortunately got some serious injuries. He may well be left with lifechanging problems. Hello. Right. Okay. So, this is Darren. He’s missed his landing site and he’s plowed into the side of a semi- detached house. After the handover, Darren will be taken for MRI and CT scans. He’s had one FFP and a gram of TX here. Yeah, that’s it. Get here now. Thank you. Given what’s happened to Darren, I think he’s incredibly lucky to have survived. Not many people have parachute accidents and live to tell the tale. RAF Benson, home to the Tempame’s Valley Air Ambulances Twin Engine Airbus H135 helicopter. Pilot Alfasparrow has been flying Helmed 24 for over 17 years. Being a helicopter pilot and being a part of the air ambulance is just something special. It’s great working as part of a team with paramedics and doctors. Every job that we go to has its own challenges. Sometimes just getting all the equipment in the helicopter can be one of the biggest challenges. Yeah. What? Okay. You got a clip there. Yeah. So, that needs to go in. Working alongside Alf today are paramedic James Perks and Dr. Zulfie Ahmed. Alf and Zulfi are both keen bikers. I’ve had a lifelong obsession with motorcycles. Started riding when I was 10 years old. Our current bike, it’s shiny. It’s got lots of chrome, very powerful. Nearly 18 years on the air ambulance. I’ve been to probably over 1500 motorcycle accidents. But I still ride my bike every day and it has never put me off. It’s my passion. Attend the car over. 8 hours into the shift, a call comes in. Go. Roger. That’s a receive gen. It sounds like another motorcycle accident for the team to attend. Always southwest to a rural location in Barkshshire. They should arrive in under 10 minutes. Al, did you hear the story? Was it RTC? Motorcyclists. I think details were sketchy. There’s a crew ahead of us. That’s the best information we’ve got. Okie dokie. In the UK, motorcyclists make up the largest proportion of road crash admissions to A&D and account for around 19% of all road deaths. We do go to a number of motorcycle accidents. You’ll see everything from somebody who’s just slipped over and they’ve got a bit of a gravel rash all the way up to unfortunately death. Right. Okay. Okay. So, there looks as if it’s right at the junction there. Yeah. So, we’re going to go and land on that smaller field. It’s just on the other side of the road sign there. Yeah. Okay. Looks like he’s come through the hedge there. Okay. Good to go. There’s just one motorbike involved. The rider Hannah has been thrown from her bike through a road sign and is still trapped. Hello Hannah. I’m James. This is Zopie just behind you. Sorry. I’m going to step on some of this stuff. All right. It’s the ambulance guys. All right. Can you tell us what happened? I don’t remember that. She’s she’s done a endo coming from where them skid marks are. They’ve gone straight through these signs straight over the handlebars of the bike. Sure. Hannah’s leg got caught in the sign which was made up of flexible slats. So although she’d actually gone through the sign, it was preventing her from moving. As it turns out, Hannah and her friend Russell were on their way home from a charity bike ride in aid of the air ambulance when the accident happened. Hannah, do you remember anything about it at all? No. No. Okay. Hannah must have gone over her motorbike to have landed into this sign. It would have been quite a rapid deceleration and that may have broken something. You all right? No. Okay. How bad is this pain? I have pain here in my in your hip and my and your shoulder. Okay, I think I can move. Okay, you don’t need to move. We’ll get them moving for you. With Hannah still wedged in the sign in an awkward position, it’s difficult for Zulfi to make a full assessment of her injuries. She may have completely smashed the pelvis up. She may have broken both legs. We need to get her to a place where we can examine more carefully and then do interventions if they’re needed. Let’s get IV access first. Are you on any tablets normally? No, I’m not on medication. Before giving any drugs, Zulfi checks Hannah’s medical history. You don’t suffer from diabetes or anything? No. Okay. Hannah, shot scratch coming. One, two, three. Well done. Lovely. Jumply. Where’s Alf? What do you reckon we can do with this sign? pulling back our break. With no fire service or police on scene yet, Alf steps in to try and free Hannah as best he can. Okay, let’s just give two ms. This is ketamine. Yeah, double checked. 10 mil syringe. Yeah. All right, so this stuff is going to make you go a bit wild. All right, just bear with me. Zulfi gives Hannah ketamine, a potent analesic which will make her more comfortable during the difficult extrication. It’s important to warn your patient before you give these drugs that they may have altered sensation. Not telling them and giving them a drug will freak anybody out. Okay, that’s going to help. We are going to move you. It’s going to be a bit uncomfortable. Okay, this way. Yes, please. Let’s do that. The dog is here. Good. No, no, you’re still there. Um, you’re all right. Relax. Just tell me your name again. One of the best things that we can do is keep patients calm so they know that we’re on their side and we’re helping them. You’re okay, Hannah. Yeah, you’re a star. Thank you. Yeah, don’t worry. Just feeling a bit confused, that’s all. That’s going under your bum there, Hannah. I’m going to take the neck. You guys all ready? Should we bring her back this way first? Yeah. Okay, we’re going to turn on three. One, two, three. Well done, guys. Good, good, good. Right. Sophie, have you got a neck? I have. If the spinal cord is damaged, that’s quite disastrous for the patient. You need to keep the head stable. So, when the helmet is removed, that’s going to minimize any movement in any potentially damaged areas. Okay. Well done, Hannah. Back. Hello. Hi. Got it. The pain’s gone though, hasn’t it? No brain. Okay, so we’re going to lift on three. Is everyone ready? One, two, three. Lift. Lift. Lift. Good. The team move Hannah into the land ambulance where they can now carry out a full examination. Perfect. Brakes on, please. Hannah. Yeah. Does that hurt? Yeah. Yeah. My right shoulder. What’s hurting? Not hips, but your back. under my hips. Okay. Your bum. Hannah might have badly damaged her pelvis. That can cause catastrophic blood loss. Without having X-ray eyes, it’s difficult to say. We need to stabilize the pelvis. Zulfi and land paramedic Susie apply a pelvic binder while James gets the monitoring ready to check Hannah’s heart rate and breathing. Everything. By the way, so far Hannah is looking very good. Putting the splint on is a form of pain relief in its own way by stabilizing any broken bones. Thank you for being here. And I’m pressing. Yeah, I got one. Yeah. Yeah. Yeah. Not at the moment though. I came in on a helicopter today. We’ve just given 22 ketamine. So you can give a paracet tomorrow. Okay. So we’re just going to ultrasound you just to make sure that all the things that are meant to be in there are in there. The portable ultrasound machine will help Sulfi and James identify any internal damage to Hannah’s chest and lungs. That’s the rib. Yeah, there’s in between. Breathe. The punctured lung is something that could potentially be life-threatening. And the ultrasound will allow us to see or interpret what’s happening underneath the skin deep down. You can see it should go to the other side. Right. Lungs are both up. Everything’s good. We’ve ruled out any major injuries to her heart and lungs. She’s got pain in her shoulder, her elbow, and her hip. She’s going to go to a hospital where they will have x-rays and they will be out to assess which bits are broken. Thank you so much. No problem. Whenever we attend a motorcycle collision, it’s always a sobering thought. It does make you think about how fragile life can be. Hannah was wearing good quality motorcycle wear. Without the leather, that’s half her skin gone. Without the helmet, she would have been dead. To avoid moving her again, Hannah will go to the John Ratcliffe Hospital in Oxford by land. The crew will have her at the major trauma center within 20 minutes. We were all glad that we could help Hannah and hopefully eased some of the distress that she felt. T-side International Airport, home of the Great North Air Ambulance. The charity costs £5.2 million a year to run with each call out averaging £5,000. Speaking, so where is he? Late into the shift, an emergency call has come in. Dr. Doogie House and paramedic Colin Clark are on the comm’s desk. So he’s fallen. A man has fallen 40 ft from a ladder at work. We’re just having a look at it now. Yes. Awake. Yes. Falling from height is the single biggest cause of workplace deaths in the UK. Reason for the fall known there is bleeding. Colin radios the land team on scene for more information. He’s been doing some work inside a warehouse some cameras from the ceiling. He had no recollection of the fall. Um it looks like he’s got um cludas skull fractures. Got some bleeding from his right inner ear. The patient’s confused. They’re combative. There’s potentially blood coming from their ear. All these could certainly be a sign of a significant head injury and this is someone that we need to be assessing. The patient is 85 mi away on the Cumbrian coast. The T-side crew are the only hems team available in the region. They deploy immediately. I think it probably is going to be with you approximately 45 minutes. Um, but we are not sure that we’re going to get there due to the weather. This is a long flight to the other side of the country. The weather’s not brilliant. We may not get that far. Yeah, we’ll just punch up above the cloud. We’re just in between layers at the moment. We’ve asked the land crew to start making the way towards Carile and we’ll intercept them if we can get that far. Yeah. Hi, this 63. Is there any way you can suggest? We could probably meet you at travel 596 to car at the minute. Yeah, roger. That’s received. So, they’ve just left s now. So, if we start heading towards Wington, I don’t know how far we’re actually going to get there. There’s low cloud. There’s a lot of rain. Need to be able to let down through the cloud. And if the cloud base is 1,000 ft or less, then we may have to turn back. Brain injuries can be very time critical. We need to get someone with a serious head injury to a neurosurgeon. The longer we wait, the potential for significant harm does increase. So we need to get there as quickly as we can which is carrying a patient with a suspected head injury. Just starting to come off the high ground now a slow descent. But the journey has been hampered by bad weather. I’ve got some fields I think coming in at 11:00. Yeah visual. That’s good vis there mate. Is it? They’ve dropped down through the clouds and with better visibility can continue with the mission. Uh, have you got a location on the crew over Roger? Yeah, the crew are just coming through a spare trail. Roger this intersection. Yeah, it’s the 596. As long as they haven’t passed us. I didn’t see them, did you? I haven’t seen an ambulance. Right. He’s a failed. That’s the one. Yep, that’s the one. on. The crew meet the land ambulance on the edge of the A596 just outside Wigton. Hello. Hello. Hello, Doogie. Paul. Hi. How are you? All right. How you doing? Yeah. So, what’s been going on? All right. This is Andrew. Y Andrew’s been working in just in his warehouse. He was at seeing height. Andrew was removing cables from a roof when he fell. Paramedic Mia was one of the first on scene. He’s had 4 milligrams onatron IM and he’s had 10 milligrams of morphine IM because we really struggled to get some IV access on it. The land crew have already given Andrew pain relief and anti-sickness medication. Andrew. Hello. Hello sir. My name’s Doogy. I’m one of the doctors with the air ambulance today. How are you doing? Well, I’ve been better. You’ve been better, I’m guessing. What’s sore? The head, the shoulder. Yep. And the left leg. Do you mind if I have a quick look at you just from top to toe and see if we can figure out what’s going on? It’s it’s also lost his strength as well. That’s okay. Big deep breath for me and out and in. And is that sore at all? We’re happy with his breathing. We’re happy with his blood pressure and pulse. Lift this leg up for me. I check he’s got good movement and strength in his arms and legs. And that would imply that the spinal cord itself is definitely intact. Good, man. And rest that one down. I know it’s sore. This one. Fantastic. Kick a ball with that one. Not just yet. Let’s take things one step at a time. Can I have a look at your head? Okay. Can you turn your head that way? Can you turn your head this way? Can you lift head off the bed? It’s not painful at all. No. Okay. So, have a good look at your ear. There’s definitely there is a bit of blood. One of our concerns is could this be a sign of a skull fracture? And if someone has a skull fracture, the chance of them having a brain injury underneath is much higher. Is this sore here? No. No. Around the back of your head. I’ve got the front your forehead. Really? It’s your face that’s taking all, isn’t it? Clearly, considering Andrew has fallen 30 to 40 ft and has landed on his face. The fact that we’re not currently finding significant life-threatening injuries is both reassuring but also quite remarkable. He’s certainly got a very bruised and battered face. His nose appears broken. He’s missing teeth. All those injuries are going to hurt. Should I have a go at getting a can? Yeah. The land crew had struggled to get IV access when they arrived, so had injected pain medication directly into the muscle. Although Andrew’s received intramuscular analesia, the absorption rate’s fairly slow. If we can gain IV access, we can get analesia straight into Andrew’s bloodstream and that’s much more effective. I have got tropical disease and where do you get that from? Uh biz in the army. Don’t worry, I’m in the navy. Well, somebody asked for me. It’s always nice to treat another serviceman. There’ll always be that friendly interervice rivalry, interervice banter which can really lift people’s spirits and just be good for everyone all around. I’ll grab the ultround and we can have There are numerous reasons why we can have problems finding a vein. One of the things we carry is an ultrasound machine and that can help us locate a vein. Prop your arm nice and straight forward. Vascular ultrasound sends out highfrequency sound waves which bounce off different types of tissue. The ultrasound really shows us the exact path of the vein, where we need to put the needle and how deep it is so that we can get to those difficult veins. That good. That’s one there. Yeah, there we go. With a vein located and a canula in place, Andrew is ready for intravenous pain relief. Try some paracet. Yeah, that might help. He may well have some facial fractures. Probably got a broken nose. He’s lost some teeth. He may have done something to his shoulder. The consequences of a head injury can be very, very significant. And the land crew have done exactly the right thing to request our support. Cheers guys. Take care. Cheers. But Doogie and Paul are now happy for Andrew to continue his journey to the Cumberland Infirmary just 15 miles away in Carlilele under the care of the land team. Andrew seems stable. We can rule out any life-threatening injuries. He still needs a full assessment in hospital, but we don’t need to take him to a major trauma center. I suspect Andrew’s injuries will take some time to heal. However, they could have been so much worse. We’ve lifted 2032. Heading back to your cell. Roger. RAFB Benson in Oxfordshire. From here, the Tempame’s Valley Air Ambulance provide emergency medical care for 2 million people living in Barkshire, Oxfordshire, and Buckinghamshire. On duty, Dr. Stuart McMorren, paramedic Simon Wetenhal, and pilot Marcus Doyle. There’s a lot of roles that we need to carry out and help each other with, and we’re a close-knit team with a common aim. We’re working together to help people when they need it the most. Each day, the pilot leads the team’s aviation briefing. Fair bit of shower activity on the front as well. Today, there’s a lot of bad weather forecast. isolated 3,000 m and heavy showers of rain and heavy thunderstorms mainly in the south. Heavy rain is a problem. It reduces visibility. If there are anticipated problems with the weather, I’ll be keeping an eye on it. So, that’s something to keep everybody updated on throughout the day. Good. A call’s come in tasking the crew to a man in his 50s in cardiac arrest. It’s a 47mi flight northwest to a village in the Cotswwells just outside their normal patch. They should arrive on scene in around 20 minutes. Element 24 desk. Our ETA to the overhead is 1447. Just confirm this is a cardiac arrest 55. Correct. Over. Received 25. If somebody’s in cardiac arrest, their heart is stopped and they’re not breathing for themselves. There’s no blood pumping around the body. There’s no oxygen going to the vital organs, particularly the brain. The brain can survive for around 6 minutes after the heart stops any longer and the brain will start to die. Coming up. Yeah, there’s a big band of them working the way up from the southwest. So, we may have to work way around those. Okay. I’m just going to bring the height down towards 500 ft. When there’s bad weather on routes, we’ll try to avoid it. We’ll try to fly around it or bring the height of the aircraft down and we’ll fly beneath it. Put the wiper on. 650 on the radar. Now, rad or radar alimter is a safety system used to measure how close the helicopter is to the ground. See if we can get into any clear whether that’s side. Nice job. Little bit worse weather than forecast. Yeah, we got 550 ft on the rad. Having successfully negotiated the weather, Marcus has them above the incident location in just over 20 minutes. See if we’ve got anywhere that’s got easy access. Yeah. What about the field? 2:00. It’s got like basketball nets in it. down wash potentially in the gardens, but I’ll keep the height up and we’ll uh yeah, we’ll reposition to that site there. Happy with that? Happy in the 7:00. That path will take us straight to the address. Okay. If we do fly, we could get the truck down that track. Yeah. The land crew have already moved the patient to their ambulance. Hi. Hi. How you doing? I’m just a gentleman who’s been discovered in a black state half off his bed with noisy breathing. Yeah. The patient Ian had been on his own for 5 days when his housemate returned home and found him unconscious. Just trying to be now to try and get his resp been up to 32. Yeah. A typical respiratory rate for an adult is 12 to 18 breaths a minute. Ian is breathing abnormally fast. His blood pressure was very low. His breathing rate was very high. And he was unconscious. He was on the verge at any point of his heart stopping and going into a full-blown cardiac arrest. Counts collide. Midnight whispers. Time to ride. Champagne kisses bold and free. Raise your glass. Stay wild with me. Bang bang. The night lights night. Firework skies. Oh, what a sight. Toast to now. Toast to dreams glow with hope like laser beams. The crew of Helmed 24 are treating a 55year-old man who was found in a collapsed state and is still unconscious. We decided to give Ian a prehosp emergency anesthetic. This involves giving a combination of drugs through an intravenous canula in order to induce him into a coma. Once he’s in a coma, the crew will be able to take over his breathing, which will maintain the supply of oxygen to his heart and other vital organs. Hem’s desk, we are clinically committed. I’ll give you an update on how we’re going to transport over. Simon starts prepping the anesthetic drugs and equipment. He and Stuart have made a decision to perform the procedure outside to give them more room to work. Should we do the checklist? Yes. So uh preoxination he is on non-rebaver at the moment. Yes. Drug dosages calculated O2. We’ve got two anesthetizing a patient at the roadside and taking control of their breathing is a complex procedure. One way of ensuring that we are properly prepared is to use a checklist. Using a checklist does add time to the procedure but it ensures safety. Ensures that no vital step is omitted. Plan A BVL. Yep. Plan B will be B superclotic airway C BVM D surgical airway but within that we can change operator right unfortunately the weather is on the turn again best lay plans 1 2 3 roll but with everything prepared and the patients condition time critical everyone agrees to go ahead outside right so you’re ready to start ready to start 40 of fentinil the anesthetic involves three drugs drugs. Okay. And he’s going to have 80 of rock. The first two drugs are to induce a state of deep sedation. And then the third is to induce a state of paralysis. Fully anistthetized, Ian is no longer breathing. Simon inserts a flexible plastic rod called a bougie into Ian’s airway. Using a video luringoscope, he can see as the bougie reaches the vocal cords. Bend. There we go. It’s not quite It’s sticking against. But the bougie isn’t going between the vocal cords as it should. Is that in? No. No. Simon has only 30 seconds to insert the breathing tube before Ian starts to run out of oxygen. There’s some resistance back out. Reoxygenating. Sometimes just a change in the position of the patient can make a big difference. sometimes or changing the operator may be all that’s required. Going to have a look. Yeah, change operator. Having changed the angle of Ian’s head and neck, Simon and Stuart switch roles. Okay, that’s still dropping. And bushy. This time the bougie passes easily through the cords and will now act as a guideline for the breathing tube to pass down into Ian’s windpipe. Tube your fingers. I have the bougie. Okay. 23. Okay. 30 bougie coming out. Popping the circuit on. Seeing the breathing tube finally go down brings a great sigh of relief because we’ve managed to overcome a very difficult part of the patient’s journey. Inflate that cough. How’s that? Y Stuart and Simon now have full control of Ian’s breathing, but he still needs specialist care. Let’s get him back in the dry. How are we doing satwise? 55 coming up. Ian will be flown to the John Radcliffe Hospital in Oxford. 24 Heaven’s desk. Our ETA at the pad at the JR will be 16:05. Over. Ready, steady, left. Have you got a cross? Yes. Weak. Weak. Ian only has a faint pulse in his neck. This means that his blood pressure is very low. He could deteriorate further. Definitely not out of the woods. Sorry, Marcus. We’re just trying to get a bit more saber 88. And I’ll get the Lucas on him. As a precaution, Stuart and Simon fit the Lucas machine, a mechanical CPR system. Should his heart stop, we could use the Lucas device to deliver the chest compressions while Simon and I continue to resuscitate him. On this side, this is especially important in the helicopter when access to the patient is very limited. That’s 91. getting the right direction. With a top speed of 160 mph, the helicopter will be at the hospital within 15 minutes. Going to come around to the left initially away from the SH. Okay, weather’s all looking good on route now. Super Ian is extremely unwell and his prognosis could be very bleak. 3 minutes landing chap. He hadn’t been seen for 5 days when his flatmate found him. If it been any longer than that, he may not have even survived to the hospital. Ian will soon undergo a CT scan which may shed some light on the reason for his collapse. Once we’ve handed the patient over to the hospital, we don’t always hear how they fare. There’s often patients who stick in our mind, particularly Ian, who was very, very poorly, and we’re always wondering how they’re progressing. It’s all cleared up, isn’t it? That’s the British summer for you. I can’t do anything that I used to do. I’ve got ankle injuries, arm injuries, wrist injuries, pelvis injuries. The one injury that scared me the most while I was in hospital was my spine. The day the physios had got me up, I cried. Not because it hurt, but because I was so happy. Because I knew I hadn’t busted my spine in such a way that I’d never walk again. I do think about that. Inch one way, inch another way, and I wouldn’t be here today. Um, it could easily have gone a different way. It’s still hard to think about, not going to lie. I’ve been skydiving for about 2 years now. It’s a completely different world. But will I ever get in a plane again, not to jump out of? No. I can’t put my wife, my friends, or anybody around me through that. The future for me is bright because I’m alive. Whatever the future is, I’ll make the best of it. I think there’s a number of times where we meet patients at the most critical moment in their lives and hopefully by us being there we can make a difference and that’s what we aim to do every day.