Rebecca Selkirk

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.

Yorkshire Air Ambulance’s Nostell-based Critical Care Team, comprised of Paramedics Terri-Ann Lonie and Dr Dan Slane, were immediately dispatched 13 miles to the village of Burn in North Yorkshire.

Upon arrival, the crew joined land ambulance paramedics to assess Beth’s injuries. Thankfully, she had remained conscious and was wearing both a helmet and back protector at the time of the fall, helping to limit further injuries. However, after assessing her injuries, Dr Dan confirmed she had sustained a suspected femur fracture, an injury that, due to the size and strength of the bone, can cause significant internal bleeding.

Terri-Ann said, “She was in a lot of pain when we got there. With a femur fracture, the broken bone can damage nearby blood vessels, so we work quickly to manage pain, assess circulation, and realign the leg.”

To keep Beth as comfortable as possible, the YAA critical care team administered a carefully controlled combination of morphine and ketamine, along with gas and air, all commonly used in emergency medicine. Ketamine is particularly effective as it induces a dissociative state, helping to reduce both the patient’s awareness of their injuries and their stress response. Throughout the process, the crew remained calm and reassuring, speaking gently to help keep Beth relaxed. This approach is an essential part of care when using ketamine, as the drug can cause sensations of dizziness or disorientation

With Beth comfortable, the team applied a traction splint to straighten and stabilise her leg. The device uses metal rods and straps to gently pull the leg into alignment and relieve pressure on the fracture. Once complete, Dr checked for a distal pulse to ensure blood flow had been restored.