A Day in the Life

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Matt Cannon has been a paramedic with the NSW Ambulance Service for six years. Like so many health professionals, Matt’s role can be demanding, rewarding and at times heartbreaking but above all, essential to the wellbeing of our community. Here, Matt gives us a glimpse into what it’s really like to work a shift as a Sydney paramedic.

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06.30: I arrive at the station to commence pre-shift preparation including a full check of the ambulance, medical and medication kits in preparation for a busy day ahead.
07.00: My shift starts and it’s time to check emails for important station memos and communiques from senior management.
07.02: We are called to respond to a motor vehicle accident, with two cars reportedly involved in a nose to tail collision. While the collision has only resulted in minor damage, we are informed a 72-year-old female is suffering from shock as a result of the incident.
07.10: My partner, Christie and I arrive at the scene of the collision, survey the scene and provide a report to the control centre. We then proceed to assess two patients.
07.35: Once we have completed a comprehensive assessment of the 72-year old female patient, with no acute health problems identified, we provide her with some general reassurance and arrange for someone to pick her up before departing the scene.
07.56: We are called to provide non-urgent transport from a District hospital to a Major Tertiary Hospital for a 75-year-old male patient. He is going for an angiogram after he presented to the emergency department earlier the prior evening suffering chest pain.
09.30: Following a successful patient transfer to the care of staff at the tertiary hospital, both Christie and I enjoy a well-deserved coffee from the hospital café (a rare opportunity).
09.45: On our way back to our base station, we are diverted to a tend to a 35-year-old male patient who is reported to have fallen eight metres from scaffolding, landing on concrete at construction site.
09.52: On arrival at the scene, Christie and I don a helmet, safety vest and safety goggles. We are taken 75 metres down a scaffolding stairway to find the male patient lying unconscious, with significant bruising to the chest and abdomen and laboured breathing. We commence immediate assessment, identifying the likely problems affecting the patient, including;

1. An ‘at risk’ airway,


2. Likely bilateral pneumothoraces (abnormal collection of air or gas in the pleural space that causes the lung to ‘collapse'),


3. Possible abdominal bleeding as evidence by abdominal rigidity and bruising,


4. Possible fractured pelvis

We commence our treatment by inserting a laryngeal mask airway into his airway. Urgent ambulance backup arrives to offer further assistance. The patient’s chest is decompressed by inserting a large bore needle into both sides of his chest. This has an instant effect, resulting in obviously improved breathing. A splint is then applied to his pelvis along with manual immobilisation of his neck.
10.30: The patient is loaded into the ambulance and transported urgently to a Major Trauma Centre in a critical condition. The police provide an escort to hospital to clear traffic, allowing the ambulance to move more freely.
10.55: The patient is offloaded into the resuscitation area at the Trauma Centre.
11.30: After restocking vital equipment, we are ready to depart.
11.38: Control Centre direct us to respond to a 78-year-old lady in a nursing home, who is reported as having a two day history of fever. She is assessed and taken to hospital.
13.40: After a long morning, the Control Centre then send us back to base station. On the way we pick up lunch from a cafe.
13.55: Before we arrive back at base, the Control Centre directs us to respond to a patient exhibiting abnormal and violent behaviour at a home unit. The notes sent down to our mobile data terminal indicate that the patient has a history of violence and drug use. We respond with police not far behind. On arrival we wait outside the premises until police arrive.
14.05: We are joined by a number of police officers before proceeding to the unit. The patient refuses to open the door and can be heard screaming inside the premises. An object is hurled through the front window, sending glass flying. Police decide that it is necessary to force entry into the premises.
Several police officers race into the room to find a male patient bleeding from both arms. He is alone in the apartment and has been cutting himself with a knife. The pungent smell of years of alcohol and tobacco in the room is intoxicating.
While police hold the man down to protect him from further harm, we attempt to talk to him and provide strong reassurance. Unfortunately the man is too drug affected and cannot be reasoned with. Our last resort is to administer sedation to protect him and others from further harm.
The patient is placed under Section 20 of the Mental Health Act, allowing paramedics to use restraints to facilitate him receiving mental health care at hospital. He is placed in restraints and loaded into the ambulance.
14.30: By this point the sedation has started working and he is now drowsy but rousable. We arrive at hospital where he is admitted to the resuscitation bay.
15.30: Once again we are returning to base station only to be re-directed to treat a 12-month-old child who is described as having a fitting episode. The notes indicate she has had a high fever for two days. On arrival we are greeted at the door by the mother holding her baby. While she appears outwardly calm, it is clear she is understandably panicked.
We immediately load the patient into the ambulance, who by this point has stopped fitting. We measure her temperature at 40C. We reassure the mother that febrile convulsions can sometimes occur in young kids with fever and this this is usually isolated event and seldom an ongoing problem. She appears greatly reassured with this advice. We take this patient to the district hospital where she is assessed in the children’s section and returns home several hours later.

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“While police hold the man down to protect him from further harm, we attempt to talk to him and provide strong reassurance. Unfortunately the man is too drug affected and cannot be reasoned with. ”

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18.05: It’s near end of shift - we finally get back to base station, but as we open the station door the emergency phone rings. We are called to treat a 58-year-old reported as suffering chest pain, with a history of cardiac health conditions.
After battling through peak hour traffic, we arrive at the location to find the patient with his wife and children. He is clutching at his chest. His wife indicates he didn’t look well when he got home from work at 17.45. She tells us about his heart attack two years ago. She says his blood pressure is still high and he indulges in “a few too many ice creams at night.”
We commence assessment; including measuring his vital signs and conducting a 12 lead echocardiogram (ECG). Assessment of the ECG immediately indicates he is having another heart attack. We commence immediate treatment, including administering aspirin, glyceryl trinitrate, inserting an intravenous cannula and providing morphine for pain relief.
From the patient’s bedroom, his ECG is transmitted to an interventional cardiologist at the designated PCI (catheter laboratory) unit. Within minutes, I receive a return phone call from the doctor. We have a lengthy conversation and decide the patient needs to be brought into the catheter laboratory urgently.
It’s now 40 minutes since his onset of symptoms and we only have a small window of opportunity to prevent permanent damage to his heart - he needs the cardiologist to insert a stent urgently. We really need a clear run to the hospital.
19:05: after pushing through traffic we arrive at the hospital where  the cardiology team meets us in the emergency department and we progress up to the catheter lab. An angiogram shows the patient had massive occlusion of his left anterior descending coronary artery. In the old days, this patient probably wouldn’t have survived. Because paramedics are able to identify these conditions very early on, we can divert the emergency department, taking the patient right to the theatre, thus minimising delays. Truly lifesaving stuff.
20.00: We arrive at base station. Our shift was meant to finish at 19.00, but emergencies don’t happen on your time!
20.30: After cleaning our equipment and restocking medical and medication kits, we sign off duty. That’s our day done, with an hour and half overtime.

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“We arrive at base station. Our shift was meant to finish at 19.00, but emergencies don’t happen on your time!”

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A Day in the Life is a regular column opening the door into the life of a person working in their field of healthcare. If you would like to share a day in your working life, please drop me an email: ckelly@aprs.com.au.