On the front line

Before I could say "two sugars please" Paul's family estate car was transformed into a beacon-flashing, siren-blaring, emergency-response vehicle and we were hurtling towards Linton-on-Ouse at 80mph. Scorching round the tight country roads at break-neck speeds, I couldn't help thinking we were putting our own lives on the line before Paul actually got to save any.

I was terrified.

Certainly it was not the start I anticipated when I'd accepted an invitation to accompany paramedic Paul Brown on a typical eight-hour shift.

Everything was so calm when we first pulled up at the Tees, East and North Yorkshire Ambulance Service NHS Trust (TENYAS) headquarters on the A19, near Skelton.

But within ten minutes of Paul receiving an emergency call, I was staring at a mangled Ford Escort and he was treating the driver's injuries until an ambulance crew arrived to take over.

The car had collided with a Land Rover after skidding on black ice. The victim suffered minor facial and chest injuries.

"He was lucky," Paul told me as he wiped blood from his trousers, "It could've been a lot worse."

With 15 years ambulance crew experience under his belt, Paul, 37, moved into a management role last year to work as a TENYAS group officer in the Selby and Goole area.

But, as I discovered, he is still required to respond to, and often supervise emergency situations - hence the car siren and boot full of drugs, needles and other life-saving equipment.

The previous day he had co-ordinated five ambulance crews and the transfer of 30 people to hospital, following a serious chemical leak at a factory near Selby.

Seven years ago, Paul was awarded a commendation for his part in rescuing a Nestl-Rowntree worker who had been dragged into a chocolate peppermint Aero mixing machine, suffering serious injuries.

"I remember being held upside down into the machine by my legs administering aid to the man," recalled Paul.

"I often think of him and hope he's okay. I can't eat Aero chocolate to this day."

TENYAS was established in April 1999, formed by the merger of Cleveland, Humberside and North Yorkshire Ambulance Trusts.

Providing ambulances for both accident and emergency cases together with a patient transport service, it serves a population of nearly two million people within an area of 4,458 square miles.

Tough new Government emergency response targets and adverse media publicity have hit the service hard in recent months.

"We can deal with a hundred jobs absolutely perfectly, but one goes wrong and we get absolutely slated," said Gary Vale, TENYAS associate director of accident and emergency services.

Speaking from the A and E services headquarters in York city centre, Gary explained that new Government targets require them to respond to serious category A cases within eight minutes - 75 percent of the time.

He said: "Unfortunately cold target figures by no means tell the whole story. There are countless reasons why a crew might not make it in eight minutes."

During my shift with Paul, I witnessed at first hand some of those reasons.

Paul and I missed the eight-minute target to Linton-on-Ouse because black ice prevented us from going flat out - although you could have fooled me.

Time was also lost trying to locate the exact destination of the crash.

Speaking to control officer Suzanna Thompson, who takes emergency calls at TENYAS headquarters, incomplete information is the bane of her job.

She said: "Lives can depend on people giving us an accurate account of precisely where the crash or accident happened. The crews response time would be inevitably quicker."

Regardless of organisational pressures, the human demands on an ambulance crew can be extremely intense.

Every time they set out on a job - be it a mud slide or ladder fall - a person's life could depend on how quickly they arrive and their reactions once there.

I pondered this as Paul followed a Selby crew to Doncaster Road on our second call-out of the day.

We arrived to find a young motorcyclist lying deathly still in the road, his bike imbedded into the front bumper of a Vauxhall Astra.

The paramedics and technician worked together in tandem, moving from equipment to victim in a methodical, efficient display of professionalism.

I watched from the car feeling helpless and slightly sick.

Fortunately the rider, who was immobilised with state-of-the-art neck and spine equipment before being taken to York District Hospital, suffered only minor leg injuries.

Earlier I had chatted to two Selby ambulance crews at the town's station. They talked candidly about their world. It sounded rewarding, sometimes tragic, but never boring.

Station officer Paul Jackson, 47, revealed he had delivered 22 babies during his 25 years in the profession - four of them in Escrick lay-by. The first child he brought into the world, with the help of his colleague John Pawelec, is now named after them both.

John Paul Smith was delivered and resuscitated by the pair in a York kitchen. They were then invited to his Christening and first birthday party.

The child has just turned 18.

Paul said: "I've never once woken up and not looked forward to this job. You never know what you're going out to next.

"There have been times I've come out of casualty and sat on the pavement and cried when a child has died. It comes with the territory."

We had one more call-out in Selby during the shift which involved another terrifying high-speed journey, weaving in and out of the commuter traffic.

On the surface, it was a minor collision between a van and car in Barlby Road.

But the van driver had only recently undergone a serious back operation and the crash had inflamed the problem.

We were first on the scene and Paul immediately sprang into action until back-up arrived.

I donned a luminous green observer's jacket and watched in awe as the victim was delicately secured and taken away.

For me, the last few hours had been an astonishing experience and I was an exhausted, nervous wreck.

As I got unsteadily out of Paul's car for the last time I told him I couldn't believe how busy we had been.

"Really?", he answered, "I thought it was quiet. Routine."