When farmer John Harper fell from his ATV, excellent teamwork between several emergency services teams helped save his life. 

“I am 59 years old and have been farming all my life. ATV’s (quad bikes) were no stranger to me, having used them for over 30 years. On 10th April 2019, I was lending a hand with soil sampling (this determines the nutrient content of soil) and I set off on the day of my accident like it was just another day.

The incident

I was working near South Molton, North Devon and was given a map of the field. I arrived with the ATV in tow, parking the trailer in the corner of the field. I rode it across the top of the field which incorporated a valley to assess the terrain. I was happy with how steep it was and proceeded to ride across and down the hill, sampling soil on my way. I was travelling slowly, but events took a dreadful turn when the front wheels of the ATV dropped into a rut and I was catapulted over the handlebars, down the hill. 

I hit the ground with a thud and remember rolling and rolling, down, down and down. In my mind, I thought I would eventually stop, dust myself off and carry on. Initially, I thought I was just winded and that I would wait a few minutes before getting up to walk over to the ATV, which I could see with its wheels in the air further up the hill where we parted ways.   

The life-saving phone call

Thankfully, in an otherwise isolated spot, two recovery trucks were passing on a public road and from the height of their cabs, witnessed the accident. I recall the men making their way over the fence towards me; their intervention was a godsend when they called the emergency services at 2.55pm; the first life-saving call.  

Within 15 minutes they arrived and after dealing with my immediate medical needs, the first responder made the next life-saving call when he asked for assistance from the air ambulance. My lasting memory of them was a pair of scissors as they cut off my clothing. I felt the cold as my shirt was removed, then they kindly wrapped me in a blanket to keep me warm.  

What happened when the DSAA crew arrived

The crew of Dorset and Somerset Air Ambulance arrived at 4.20pm. Because of where I was situated in the field, the Hazardous Area Response Team (HART) from Exeter were called out to get me from the field to the air ambulance. I have a vague, hazy, morphine, befuddled memory of being carried to the HART 6-wheel ATV.

My wife was called to inform her of the accident and to let her know that I was being airlifted to Southmead Hospital in Bristol. It was a kind call, with lots of assurance that I was in excellent care. As I was aided towards the HART vehicle and then sat up inside, she was told that it was likely I had broken a few ribs, but more would be known on my arrival at Southmead. 

As the air ambulance proceeded to lift off, my oxygen levels drastically dropped and the take-off was suspended. On board were Critical Care Practitioner Claire Baker and Dr Tony Doyle, both of whom are trained to handle such emergencies. It turned out that a flail rib had punctured my lung and that it had collapsed. Realising this, Claire and Tony had to place me in an induced coma and I was intubated to assist with my breathing. They then performed a thoracostomy, whereby the side of my chest was punctured and a finger placed into the side of my chest cavity to release the trapped air. Without this intervention, I would not have survived. Wow, a hospital in a field - amazing! 

On landing at Southmead, Claire called my wife again, to inform her of the intubation and procedures that had taken place. 

My injuries included 14 broken ribs, nine on the left, of which four were flailing and five on the right. Flailing is when the rib cage breaks due to trauma and it becomes detached from the rest of the chest wall. I also suffered a shattered left scapula and two transverse fractures in my neck, along with a bruised spleen. I was kept in an induced coma for five days and transported to and from Bristol Royal Infirmary as their thoracic specialists needed to mend my four flail ribs, stabilizing my chest, before I could be brought out of the induced  coma.

Aftercare and recovery

On my return to Southmead, I was wonderfully cared for in the Intensive Care Unit for three weeks. Finally, I was moved to a ward and then transferred to Musgrove Park Hospital in Taunton, where I was monitored for a couple of days before being allowed home.  

God really had the best trained people available and in place on the day of my accident. The air ambulance team were exceptional and without them, I would not be here. I started a phased return to work just eight weeks after the accident and was back in full time employment just seven weeks later. I can now, once again, function using my skills in agriculture, albeit without the help of an ATV! 

I cannot thank everyone enough for the excellent care I received, but most of all for saving my life!

VIEW FROM THE CREW - Tony Doyle, Critical Care Doctor

“We arrived on scene to find John sitting on the ground on a steep hill just below his overturned quad bike. I was informed by the land crew that he had sustained a flail chest from rib fractures and I was surprised to see a very obvious left flail segment on the back of his chest. These injuries are rarely clinically obvious, because the patient is often breathing in a very shallow way to minimise pain and because of muscle spasm. With assistance, John was able to walk down the steep hill to the Polaris vehicle, which was operated by the hazardous area response team (HART) who were brilliant in assisting us that day. We judged that this was a safer option than carrying him on a stretcher. He showed great stoicism and bravery in mobilising, with what was clearly a very painful injury. The HART team then conveyed John and I to the helicopter, which was located at the top of the hill.  

On loading into the aircraft, it was quite clear that John was not going to be able to tolerate lying down, because of his pain and very low oxygen levels in his blood stream. We elected to administer an anaesthetic and place a tube in his windpipe to enable ventilation, which immediately solved the oxygenation issues. 

We also performed a thoracotomy, which is a small incision in the chest to allow any trapped air or blood to escape from around the lung, which could compromise ventilation. We then airlifted John to Southmead Hospital and handed him over to their trauma team.  

John’s good outcome is a great example of teamwork; it was a pleasure to work alongside the HART team and the land-based paramedic crew from Devon that day. We are delighted to hear that he has made a very good recovery. 

NEXT: Tracy's Story

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