St John Ambulance officers work under pressure in life-and-death situations every day across Northland. It's a job where every second counts and St John will come to your aid at any hour of the day in almost any terrain, weather or situation. Emergency services reporter Kristin Edge joined a team on the road in Whangarei on a Friday night.
TONY DEVANNEY has been in the business of saving lives for 20 years. He exudes an air of calmness and you can tell there's not much that would faze this guy. He's seen the lot - stabbings, births, deaths, brain bleeds, falls, heart attacks and a myriad more medical emergencies.
Devanney is St John Northland operations manager and heads the medical team scattered across the region.
Tonight he's on duty in Whangarei and is ready to roll when the call for help comes.
It doesn't take long. At 7.56pm a little black pager clipped to his belt bleeps repeatedly.
A 35-year-old woman at a church service in Kamo is experiencing a headache and feeling dizzy. On the surface it appears a simple job. But Devanney knows how quickly medical conditions can deteriorate.
An ambulance rolls out of the Whangarei station with advanced paramedic Rob Gemmell and officer Stephen Boys on board, followed by Devanney in his rapid response four-wheel-drive vehicle.
The team is met outside the church by a distressed man. He guides them inside to a small room where the woman lies deeply unconscious on a pink blanket in the middle of the floor.
Devanney quickly and calmly takes control of the situation. He establishes when she last ate, how long she felt dizzy and if she has any allergies.
They hoist her on to a trolley and wheel her into the parked ambulance which becomes a mobile emergency room. The team moves quickly in the confined space, attaching numerous machines to the woman to monitor her vital signs.
She is struggling to breathe. A decision is made to put a tube down her throat and use machines to breathe for her.
Devanney steps out of the ambulance and updates the woman's husband. Once the woman is stabilised the ambulance doors close and the team heads for Whangarei Hospital. On the short trip the woman's condition deteriorates and she is declared status 1 - status 0 is dead.
As the doors open and the trolley is wheeled into the hospital's emergency department the St John team brief the doctors and nurses.
It doesn't look good. A scan reveals a massive brain bleed.
The woman's future health is now in the hands of doctors.
Devanney says people who have been in a car crash and knocked their heads can present with the same symptoms as this woman did. But it is the actions of the St John team at a scene that can make a difference with long-term diagnosis and recovery.
"Without oxygen things start deteriorating and more brain injury occurs. We stop that so their potential for survival increases greatly."
Being with St John is a job full of surprises, he says. "You can't predict it, either. The emergencies aren't all on a Friday or Saturday. People are still fighting and hurting each other on Mondays and Tuesdays. Suddenly it all happens. It can go from very quiet to full chaos in minutes."
Devanney reckons the best part of his job is the unknown.
"It's like a CSI discovery trying to work out what is wrong with a patient. The rewarding part is getting to the end of it and finding out what is wrong before we get them to hospital. That hasn't stopped since day one.
"It's the sort of job where coming to work every day is different and every patient is different."
He estimates 70 per cent of the calls in Northland are medical while 30 per cent are trauma related.
After years of saving lives there is still one thing that turns his stomach and that's the smell of vomit. "I've got a sensitive stomach. I will never get used to the smell."
In Northland there are 48 paid staff and 261 volunteers working from 19 stations and using 32 ambulances. Devanney is under no illusion as how important the volunteers are.
"If it wasn't for the volunteers we wouldn't have a service. They are a huge asset especially outside of the main centres."
Last year St John in Northland attended 12,402 callouts, with 1647 calls to sick people with a specific diagnosis, 1546 calls to breathing problems, 1193 to falls and 1156 to chest pains. Last year's statistics also include 15 jobs involving stabs, gunshots or penetrating trauma, 14 call-outs to near drownings or diving accidents, 33 choking incidents, 265 assaults and sexual assaults and 13 animal attacks or bites.
All ambulance officers are trained under a nationally accredited programme.
After achieving the National Certificate in Ambulance (Patient Care & Transport) they progress through intravenous and cardiac qualifications to become St John paramedics. Those who complete the National Diploma in Ambulance (Paramedic) then become advanced paramedics. Ambulance officers also have the opportunity to complete a Bachelor of Health Science paramedic degree programme.