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Lights, sirens and cardiac arrest: A night out with Sydney's ambos

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The pokies room is full at Easts Leagues Club in Bondi Junction, though not with the usual suspects.

On the gaudy, casino-style carpet a 49-year-old man lies unconscious, his eyes rolling to the back of his head, having suffered a cardiac arrest only moments earlier.

NSW Ambulance paramedics and police officers perform CPR on a 49-year-old man who collapsed having suffered a cardiac arrest.
NSW Ambulance paramedics and police officers perform CPR on a 49-year-old man who collapsed having suffered a cardiac arrest. Photo: Wolter Peeters

Five hours earlier NSW Ambulance paramedics Eugene Roser and Gareth Garne are on their second night shift in a row.

While the city is mostly sleeping, Sydney's paramedics are kept busy.
While the city is mostly sleeping, Sydney's paramedics are kept busy. Photo: Wolter Peeters

"I'm really surprised that we're sitting around," Mr Roser says, never leaving more than a few minutes before checking his portable shoulder radio, a fifth limb for the remainder of his 12-hour shift.

This evening, Mr Roser is the designated driver.

In quiet periods, paramedics are encouraged to recline and rest, before the next job.
In quiet periods, paramedics are encouraged to recline and rest, before the next job. Photo: Wolter Peeters

As intensive care paramedics, or ICPs, both he and Mr Garne are among the most senior paramedics on the road, trained to handle complex cases and administer high-level cardiac drugs and opiates, like ketamine.

"That's a relatively new drug for us ... it really is fantastic. It's a dissociative, so it would be used on someone with a broken leg that needs straightening up," Mr Roser said.

Paramedic Gareth Garne (left) loads the Leichhardt man into an ambulance.
Paramedic Gareth Garne (left) loads the Leichhardt man into an ambulance. Photo: Wolter Peeters

"The best way a patient once described it to me was that they knew they had pain, but it was like they were on the other side of the room watching it."

The pair are enjoying a coffee on Newtown's King Street when a call comes through around 11.15pm.

A NSW Ambulance paramedic checks equipment and drug supplies during his shift.
A NSW Ambulance paramedic checks equipment and drug supplies during his shift. Photo: Wolter Peeters

A 70-year-old man in Leichhardt is having breathing difficulties, and reportedly changing colour.

On the car's internal call log it comes through as a category one job, which means "lights and sirens".

NSW Ambulance paramedics restock their medical kits at St Vincent's Hospital.
NSW Ambulance paramedics restock their medical kits at St Vincent's Hospital. Photo: Wolter Peeters

Travelling at 100 km/h and with little traffic along Parramatta Road, the ambulance reaches the home in no time, with Acting Superintendent Chris Anson close on its tail if support is needed.

After picking up the elderly patient and delivering him to Royal Prince Alfred Hospital, it's one-patient-down for Mr Roser and Mr Garne.

Paramedic Gareth Garne shares a laugh with an 82-year-old patient from Bellevue Hill.
Paramedic Gareth Garne shares a laugh with an 82-year-old patient from Bellevue Hill. Photo: Wolter Peeters

"People like that you can do something for. You can rehydrate them, get their fluids up, address the cardiac side of things," Mr Garne says.

"The big traumas, there's nothing you can really do in an ambulance. You're patchwork until you get them [to theatre]."

Paramedics have 15 minutes to ensure the ambulance cabin has been fully sanitised and restocked, ready for the next patient.
Paramedics have 15 minutes to ensure the ambulance cabin has been fully sanitised and restocked, ready for the next patient. Photo: Wolter Peeters

But, he says, it is always the "higher acuity" cases [complex emergency cases] that stick with him.

"I remember we had a guy on ice, that jumped off the 18th floor [of a building]," he says. "When we got there he was actually trying to fight the police off. But he had bilateral compound fractured femurs, his lungs decompressed and half his face had been knocked off."

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Lights, sirens, cardiac arrest: A night with the ambos

It's around 1am and the patient from Leichhardt has been handed over to staff at RPA.

At this point the pair have 15 minutes to ensure the ambulance cabin has been fully sanitised and restocked, ready for the next patient.

"My record is three minutes, 32 [seconds]," Mr Roser says, adding that it's often easier to hose out the cabin in particularly messy cases.

Highs and lows

After nearly 10 years in the job, Mr Roser says the best and worst jobs involve babies.

"I've delivered four babies and that is so great ... but I went to an 11-day-old cardiac arrest not so long ago, that was horrible," he recalls.

"Mum fell asleep while breastfeeding and accidentally suffocated the baby. It was really quite surreal."

Mr Roser still remembers the mother grabbing him, saying, "I've killed my baby, haven't I?"

"How do you answer that? It's not the way things are supposed to go."

It's a little after 1.30am and the crew is arriving at a two-storey home in Bellevue Hill where an 82-year-old male has woken up with slurred speech. He is a diabetic and has a history of stroke.

12:37pm. NSW Ambulance Paramedics arrive at a home in Bellevue Hill to treat an 82yo diabetic male with stroke like symptoms, low blood sugars and a drooping right side of the face. He was stabilised and transported to St Vincent?s Hospital. 9th Feburary 2018, Photo: Wolter Peeters, The Sydney Morning Herald.

Paramedics arrive at a Bellevue Hill home to treat a 82-year-old diabetic male with a history of stroke. Photo: Wolter Peeters

The call-out is typical for this time of night, and after an abnormality appears on his electrocardiology reading, the crew decides to take him to St Vincent's Hospital.

En route, Acting Superintendent Anson, who is still with the team, hears a troubling call on the radio.

"Methadone overdose in Glebe. Patient is an eight-year-old girl."

It is 2.22am.

11:38pm. NSW Ambulance Paramedic Eugene Roser cleans the trolley after transporting a 70 yo male from Leichhardt to RPA Hospital. 9th Feburary 2018, Photo: Wolter Peeters, The Sydney Morning Herald.

NSW Ambulance paramedic Eugene Roser cleans a trolley. Photo: Wolter Peeters

As he heads towards the reported emergency, a clarification comes through from another ambulance that has already arrived.

"Looks like a custody issue. Police are here. This is not a job for us."

False reports and non-emergency calls are common for triple-0 operators, who answer a call for help on average every 28 seconds, with only 10 per cent concerning life-threatening conditions.

"I've been called twice to mosquito bites," Mr Garne says.

Back at Vinnies it has just passed 3.15am and the unconscious 49-year-old man from the pokies lounge is still down. His heart has not started in over half an hour. Sadly it won't start again.

Doctors call his time of death just after 5am.

2:14am. NSW Ambulance Paramedics and Police officers perform CPR on a 40yo male who collapsed with a cardiac arrest at Easts Leagues Club. He was then transported to St Vincents Hospital. 9th Feburary 2018, Photo: Wolter Peeters, The Sydney Morning Herald.

The 49-year-old patient who collapsed at Bondi Junction died. Photo: Wolter Peeters

By now all is quiet at the Eveleigh ambulance station, where Mr Roser and Mr Garne have returned with fellow shift mates to wait out the two remaining hours of their shift.

Around the station, weary bodies drape themselves over couches and futons on the floor.

In these quiet periods, when the city is mostly sleeping, they are encouraged to "recline" and rest their own eyes, before Sydney wakes up and the calls start once again.

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