Health correspondent Geraldine Scott spent 14 hours with one of the east of England's ambulance crews. In part two, she explores how crews can deal with traumatic incidents.
It's around 10.30am by this point and time for a well-deserved cup of coffee for the crew in the ambulance room at NNUH.
In here, a member of EEAST crew keeps things ticking over, managing patient flow. On the wall hangs a sign which reads: 'Surge amber'.
This means the trust was receiving more calls than normal - when they would be on surge green. Above amber is red, black, and declaring a major incident.
So to try and help tackle this demand, we're available again pretty quickly and sent straight to a woman in Norwich with abdominal pains. Luckily this was not serious and emergency medical technician Scott O'Sullivan was able to arrange for the woman's GP to visit the next day.
The next job to flash up on the screen was the most serious call - a cardiac arrest in Norwich. On the way I asked Scott, who was driving, how he deals with calls such as these where someone might die.
'It sounds harsh but you have to shut yourself off from it,' he said. 'It's a self-preservation thing, we wouldn't be able to do the job without it.'
On the way, it became clear the 93-year-old man had died in his sleep - at this point the crew's role changes. We arrived on the scene in 11 minutes. This is important, because for the most serious calls crews are expected to arrive within eight minutes 75pc of the time. If this target is missed, there are fines for the trust. But in my view we could not have got there any quicker.
An ambulance officer had already arrived at the home, but Scott still had to carry out checks to recognise the man had died. This, he said, was different to declaring the death, which would be done by a doctor.
MORE: Day one - 'This isn't Holby City' - A look behind the scenes on a shift with an East of England ambulance crewMeanwhile, paramedic Paul Seville comforted the family while the crew waited for the police to arrive on behalf of the coroner - which is normal for any death. Later he said: 'Once we knew that gentleman had died, I could hear a woman crying in the lounge, she's my patient now,' he said.
It was a delicate balance between being caring and compassionate and keeping a professional distance.
'We have to learn to compartmentalise,' Paul said. 'It's not a case of being heartless it's a protection mechanism.
'I can without even thinking give you half a dozen examples which have been extremely unpleasant,' he said. 'But it's a difficult one for people to understand because you don't lose your empathy, but it can make us seem cold.'
Eight hours after we first booked on, it's time for a meal break. However, it's only 32 minutes before the radio rings again, sending us to a dentist's surgery in Holt where a patient's mouth won't stop bleeding.
Halfway there we're diverted again, this time to Swanton Novers, where a 69-year-old man has had a stroke. Although the driving all day had been impressive, it was most clear in how Paul navigated the ambulance along North Norfolk's windy country roads.
He pointed out how to know exactly when the vehicle in front had noticed the ambulance was behind them - sometimes shockingly late - as well as how aware he was of his surroundings. Arriving at the scene, Paul and Scott wasted no time. It was clear the man had suffered a stroke, he was unable to speak, but showed Paul he knew what he was saying by squeezing his hand. Every second counts with a stroke, so it was straight into the ambulance, but this time Scott called ahead to ensure the stroke team was ready to meet us as soon as we arrived. This was the first time I'd seen treatment being given as we moved - no mean feat as we hurtled down the back roads.
There were no delays in transferring the man into the hospital and a specialist team was treating him straight away. Because we'd had to travel quite far to reach the man, it was 6pm by this point - just enough time for one more call.
This time, out to HMP Wayland where a prisoner was suspected of taking an overdose. Met with shouting and reluctance, this highlighted the difficult and potentially dangerous situations these crews work in every day.
But after being told he needed a blood test, the prisoner relented. However, we had to wait for night staff to arrive so the man could be accompanied to hospital. By the time we had reached the hospital and dropped the man off, it was 9.30pm. It's a regular occurrence for these crews to get off late, with the nature of the job being that you never know what is going to happen. But by that time, they had been going for 14 hours, and it was definitely time to go home for a cup of tea.
What I learned on an eye-opening day
• The number of miles these crews cover in a day is astounding - we spent most of our time in Norwich but were also sent out to North Norfolk and Wayland prison, and by the time the shift was over we'd travelled around 137 miles.
• There is no time for breaks - as soon as we were clear from a job it was straight back onto the road and another call was in, there was no time to hang about and wait.
• Demand is rising - this is not a surprise as often we cover stories of long ambulance waiting times, and I experienced myself being diverted to more serious calls. The reality is that those less serious calls just have to wait if it means a life could be saved.
• More paramedics are needed - to try to tackle the demand problem, the trust needs more staff. I know they're putting efforts into this and the first cohort of student paramedics from UEA have just graduated, so hopefully the gap will begin to be filled.
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