Paramedics nightly drive into danger

By SCOTT INGLIS

The 111 emergency call comes in just before 8 pm. A chef at an Auckland bar and restaurant has been reportedly stabbed in the stomach by accident and needs urgent help.

Two senior St John Ambulance officers, Lance Wright and Steve Browne, respond, turning on their lights and sirens.

An accidental stabbing should pose no risk but both know from experience that a seemingly benign callout can turn out to be something dangerous.

Fresh in their minds also is the surprise attack on four colleagues while they were trying to restart a man's heart in West Auckland last Sunday.

Several minutes after the call, Mr Wright and Mr Browne walk briskly into the bar and brasserie and immediately ask a staff member if the stabbing is, in fact, accidental.

"He stabbed himself with the knife - I don't know how," the worker tells them.

In the kitchen, the officers find the 23-year-old chef sitting on the floor, clutching his abdomen. About 10 minutes later, he is in a life support unit on his way to Auckland Hospital - and ultimately surgery.

The callout is one of at least six attended by Mr Wright and Mr Browne on Thursday's 6.30 pm to 6.30 am shift. Others included a false call of chest pains and a collapse.

The pair are based at Auckland City's Pitt St station, the country's busiest with an estimated 22,000 callouts a year, covering Ponsonby, Grey Lynn, Remuera, Newmarket and Pt Chevalier and backing up other metro stations.

Last weekend's attack in Ranui - in which one officer was knocked out and the patient died - has raised the issue of safety on the job for ambulance officers and is a talking point among the ranks.

The service has ordered an immediate safety review, and has not ruled out self-defence lessons.

Tempers and emotions can run high in callouts, especially in medical emergencies such as heart attacks.

Many officers are regularly abused by patients and their families and friends. Many report being assaulted and some have received death threats.

But officers point out that they are the good guys, and threats, abuse and assault are unacceptable.

Thursday night's shift starts with a callout just after 6.30 pm to a Ponsonby house where a man has a severe stomach ache.

Mr Wright is a 42-year-old paramedic with 16 years' experience, and 37-year-old Mr Browne is an intermediate care officer with 11 years in the job.

At the house, they find a 74-year-old lying in agony in his bed, holding a hand over his forehead and wearing just a T-shirt and underwear. He has been vomiting and there is a putrid smell throughout the house. A friend stands in the lounge, looking worried.

The patient's doctor, Michael Wah, holds the man's medical file. "He is very sick. He might have anything between a very bad case of gastroenteritis or he might have perforated his bowel," he says.

Mr Wright and Mr Browne put the patient into a fold-up chair and eventually a stretcher. In the back of the ambulance, they discover that the man's blood pressure is low and he has a distended abdomen.

It turns out he probably does have a perforated bowel and is rushed into surgery at Auckland Hospital.

Just before 8 pm, as they are about to have dinner, the stabbing call comes in. Minutes later, in the restaurant's kitchen, the injured chef is lying down. Mr Wright places swabs over the bleeding wound while Mr Browne takes his blood pressure.

Two other kitchen staff are stressed. They have orders to get out and are cooking flat-out. Steaks sizzle on a hotplate.

The injured chef groans and vomits on the floor. A staff member grabs a tea-towel and throws it over the vomit.

Mr Browne asks the patient: "How are you doing?"

"Stomach sore," is the pained reply.

In the back of the life support unit, Mr Wright works on the man, monitoring vital signs. His blood pressure is too low and Mr Browne radios ahead to Auckland Hospital to warn of their arrival.

On the way to hospital, he talks about how ambulance officers have to be wary going to any job, especially if a weapon is involved.

"You can get people ring up and say someone's been accidentally stabbed when they haven't. You've got to be a little bit cautious."

In the resuscitation room, medics cannot be sure the chef does not have a serious internal injury, and send him up to surgery. He was yesterday in a satisfactory and stable condition in critical care.

Back at Pitt St, duty watch manager Glenn Rose arrives and is talking on his cellphone, juggling ambulances, staff and coverage.

The conversation turns to safety on the job - and abuse and assaults.

"I hate to say it's a part of the job but it is," says Mr Rose, a 10-year veteran. "In any sort of crisis there's an emotive issue that goes with it and we don't have an issue with that. But it's when that stress becomes unmanageable ... and people resort to violence.

"I think the public have to realise that we're stressed as well and we're doing our best."

All three officers tell of being threatened and assaulted. Accounts also emerge of officers being told that if they cannot save someone they will be killed. Ambulance communications staff also take abuse.

Mr Rose believes arming ambulance officers is out of the question and even self-defence is not the answer. As a result of Sunday's attack, which involved Samoans, Auckland's Samoan community has contacted St John, worried that as a result the service might not respond in future.

Mr Rose is reassuring: "We will still come, but abusing us will not make us come any faster."

Suddenly, the station's alarm sounds. There has been a car crash on Great North Rd in Avondale.

Mr Wright sums up the job: "We basically see life at its worst and then you get a successful result - and it's all worth it."