Rebecca Selkirk

Yorkshire Air Ambulance’s Nostell-based Critical Care Team, consisting of Paramedic Tom Chatwyn and Dr Paul Onion, were scrambled to the scene, flying the 16-mile journey in around eight minutes. They joined a local land ambulance crew already at the scene, who had requested YAA’s advanced medical support, including stronger pain relief, the capability to give blood at the scene, and the expertise of an onboard doctor

Landing in a nearby field, the team made their way to the property where Paul was being treated. He remained calm and composed, though his leg was still bleeding significantly despite the improvised tourniquet.

Dr Paul explained, “When we arrived, Paul said his leg felt wobbly, and that matched exactly what we could see. The saw had completely broken the bone, and the lower leg was barely attached by tissue. It was a serious, life-threatening injury.”

To control the bleeding, Paramedic Tom packed the wound with a special gauze called Celox, designed to rapidly stop severe haemorrhaging. The treatment, often used by the military encourages blood to clot on contact. The team also applied a pressure bandage before replacing the improvised tourniquet with a medical-grade one, positioned higher on the leg for full control.

Dr Paul continued, “Before we arrived, Paul’s son had done an excellent job applying a tourniquet. It had already reduced the blood loss significantly. Without that quick thinking, the outcome could have been very different. Injuries that damage the major arteries or veins can cause catastrophic bleeding in seconds, and the body simply can’t stop it alone.”

Once the bleeding was under control, the team administered ketamine, a powerful pain relief medication commonly used in emergency medicine, known for its dissociative properties. As the drug took effect, the crew carefully realigned Paul’s leg to restore its natural position and reduce the risk of further damage to surrounding blood vessels and nerves. It was then secured in a vacuum splint, which moulded tightly around the limb to keep the broken bones stable during transport.

Dr Paul said, “In Paul’s case, he had two significant injuries, one to the blood vessels, which we managed with the tourniquet, and another to the bone itself. Realigning the leg early gives the best chance for those bones to heal properly once in hospital.”

With the leg stabilised, Paul was transported to Northern General Hospital in Sheffield, where surgeons were waiting. He underwent a five-and-a-half-hour operation to save his leg, during which metal plates were fitted to repair the fractures. He spent ten nights in hospital and is now recovering at home, able to walk short distances with crutches but still facing a lengthy rehabilitation.

Yorkshire Air Ambulance’s Topcliffe-based Critical Care Team, consisting of Paramedics Danny Cooper and Andy Watson, were scrambled to the scene, flying the 17-minute journey to provide advanced medical support.

Speaking en route, Paramedic Danny explained, “With the information being quite limited before we arrived, we were anticipating anything. A collision between a cyclist and a van could mean broken bones, spinal injuries, or severe burns. What we did know was that he was in significant pain.”

Landing in a nearby field, the YAA crew made their way to the scene, where they joined the rescue efforts. Tom had been freed moments earlier, covered in oil and coolant fluid from the van, with visible burns and lacerations to his back and legs. He was conscious but in significant distress, struggling to breathe and experiencing pain in his chest and back.

Paramedic Danny said, “We could tell he was in a lot of discomfort, and we needed to work out exactly what was going on. Because Tom was covered in oil, it made assessing his burns and injuries quite difficult, so we prioritised getting him into the back of the land ambulance where we could properly examine him.”

Once inside the privacy of the land ambulance, the YAA team carried out a thorough assessment, checking Tom’s vital signs and looking for any additional injuries. They carefully cut away sections of his clothing to examine the burns, which extended across his torso, lower back and side, before wrapping him in a thermal blanket to prevent hypothermia, a common risk in trauma patients. Concerned about possible full-thickness burns, the team worked quickly to wash and dress the wounds while continuing to monitor his breathing and overall condition.

With concerns about possible internal or crush injuries, Paramedic Andy administered morphine to keep Tom comfortable during transport for urgent hospital scans.

Tom was transferred to Hull Royal Infirmary, where he was diagnosed with deep second-degree burns, broken vertebrae, five fractured ribs, and breaks to both shoulder blades. He underwent a procedure under anaesthetic to clean and treat the burns and spent four days in hospital before returning home to continue his recovery.

Yorkshire Air Ambulance’s Topcliffe-based Critical Care Team, consisting of Paramedics Sam and Danny, were scrambled to the scene, arriving by air in just minutes. They joined a local land ambulance crew who had already begun a primary assessment of Maddie’s injuries and were providing gas and air for pain relief until the YAA team could deliver stronger interventions.

Speaking on the way to the incident, Paramedic Sam explained: “Sometimes with fractures you can get impingement of the nerves and blood vessels that supply blood to the extremities. If the blood flow is cut off significantly or completely and for long enough, that’s when you can lose a limb. That’s always in our minds when we attend these types of jobs.”

Once at Maddie’s side, the YAA team assessed her injuries and prepared stronger pain relief. Paramedic Danny administered ketamine, the strongest drug carried by the service which is commonly used in emergency medicine for its dissociative properties, helping patients detach from the pain and later forget the treatment they have received.

With the medication taking effect, the team began the delicate process of realigning Maddie’s leg. The fracture was complicated by the bone having broken through the skin of her ankle, making the procedure more challenging. By gently flexing her knee, they were able to manipulate the fractured bones back into position before securing the leg in a vacuum splint, which formed a rigid mould around the limb to keep it stable.

Paramedic Sam explained: “With an open fracture there’s an increased risk of infection as the tissue is exposed, as well as the danger of uncontrolled bleeding. Getting the bone back into alignment and securing it quickly is vital to protect the limb and improve patient outcomes.”

With her leg securely splinted, Maddie was moved off the ground and onto a scoop stretcher and placed in a thermal sleeping bag before being flown to James Cook University Hospital in Middlesbrough. Following the short 10-minute flight, Maddie was taken straight to surgery to repair her ankle without delay.

YAA’s Nostell-based Critical Care Team, consisting of Paramedic Wayne Jones and Dr Steve Rowe, were dispatched to the incident, travelling more than 50 miles by air to reach the isolated location. They were the first to arrive, landing over half a mile away and making their way on foot along a rough, stone track.  

While on route, Dr Steve explained the dangers of crush injuries, he said, “When patients are pinned, heavy pressure on the tissue can cause it to die, releasing toxins into the bloodstream. The longer someone is trapped, the greater the risk. That was a real concern on the way to Stephen.”

Arriving at the scene, the crew were met with multiple hazards. The tractor’s engine was still running, emitting toxic fumes, while diesel leaked from the tank. Once the ignition was switched off, the team began assessing Stephen, who was struggling with arm, shoulder and chest pain, shortness of breath, and a crushed arm with no sensation in his hand. Pain relief, clotting medication and morphine were administered to stabilise him while a rescue plan was put into action.

Working alongside North Yorkshire Fire and Rescue Service, who were brought up the hillside by local farmer Abe Dent on his quadbike, before using high-pressure air bags capable of lifting 60 tonnes to gradually raise the tractor. But as the vehicle lifted, its mudguard pressed into Stephen’s chest, forcing the team to pause and reposition.

Dr Steve recalled, “Stephen began to feel very tired, something we sometimes see with ‘peri-rescue collapse’, when patients can suddenly deteriorate just as help arrives. Given how long he had been trapped, I knew this was a critical moment where things could quickly change.”

With the risk of potassium from the crushed tissues flooding his system once released, the crew administered calcium to protect Stephen’s heart. After over two hours, the tractor was finally lifted enough to slide him free. He was quickly placed into a thermal sleeping bag to warm him and carried to the helicopter with assistance from the local Swaledale Mountain Rescue Team.

Stephen was flown to James Cook University Hospital in Middlesbrough, where trauma teams were waiting. He remained in hospital for 12 days, recovering from eight broken ribs, a fractured shoulder, broken sternum and punctured lung.

Reflecting on the mission, Dr Steve said, “In some ways, Stephen was very fortunate. The tractor didn’t impact directly in the middle of his chest, which could have caused far more serious injuries. I can’t imagine how uncomfortable and frightening the first hour must have been for him before we arrived. Where he was trapped, on top of the moors and away from any public footpath, there was no chance of anyone passing by to find him. Had he not been able to reach his phone, the outcome could have been very different. Thanks to the combined efforts of the Fire and Rescue Service and Mountain Rescue, Stephen was freed safely and taken to hospital without delay.”

During his fifth visit to the woodland, Bob began working on a large conifer tree that had been torn from the ground and was laid across the forest floor with its roots fully exposed. Resting on top of the pine was a large silver birch tree, which had also fallen during the severe winds. Bob cut several logs from the fallen conifer to clear a path to the birch. Once clear, he made a partial cut into the base of the birch, stopping short of cutting all the way through.

Bob explained, “I made a cut into the base of the birch, then walked away to set my chainsaw down safely before finishing the cut with a hand tool. That’s when I heard a loud crack.”

Bob returned to investigate the click, but before he could react, the tree snapped. As the conifer straightened, it pushed the silver birch downwards, catching it on his helmet. The movement knocked him two and a half metres into another fallen tree, where he came to rest against a stump. As he landed, the birch slid down the left side of his body, striking his shoulder and pelvis, and pinning him in a seated position on the frozen ground.

The impact left Bob concussed, but remarkably, his helmet had not broken. He said, “I didn’t feel any pain at first, but I knew I couldn’t move, and I was in serious trouble.”

Bob attempted to call for help using his mobile phone but had no signal in the dense woodland. With no way of alerting anyone and no one nearby to hear his calls for help, Bob remained trapped.

Over the next few hours, he drifted in and out of consciousness, unable to tell how much time was passing. After nearly five hours alone, Bob was finally discovered when his friend returned to the site to pick him up as planned. Recognising the severity of the situation, he raced to find phone signal and called 999 for help.

Yorkshire Air Ambulance’s Nostell based critical care team was dispatched alongside the local Fell Rescue Team. Upon arrival, YAA doctor David Driver was immediately concerned by Bob’s pale, clammy appearance and feared he may be suffering from internal bleeding into his pelvis.  

Due to the complexity of both his injuries and the location, it took some time to safely free him. A total of seven people were needed to carefully carry his stretcher through the woodland, over fencing, and to the waiting helicopter. Bob was then flown to Leeds General Infirmary, arriving at around 6pm, nearly seven hours after the accident occurred.

Scans revealed Bob had suffered a fractured pelvis in four places, five broken ribs, a cracked shoulder blade, hypothermia, pneumonia, and significant internal bleeding. He was stabilised in hospital for two days before undergoing surgery to repair his pelvis.

After initial treatment in Leeds, Bob was transferred to Airedale General Hospital and later to Castleberg Hospital in Settle for rehabilitation. His recovery was far from straightforward. Within five weeks, he required a second operation after screws in his pelvis came loose, followed by a third due to a post-surgical infection. He spent five months unable to bear weight and had to relearn simple tasks like getting dressed.