Extreme Medics: High-speed race towards ‘something terrible’
The emergency response vehicle flies through the streets of Alice Springs with its sirens blaring. This is an important and unprecedented ride into a behind-the-scenes - more precisely on the scene - look at the awe-inspiring, live-saving work of the St John's Critical Response Unit (CRU).
It's 10.30pm, just days away from Christmas and the Central Australian town's two most senior paramedics have been dispatched again.
We'd just returned to the station from another job and were standing in the staff kitchen, chatting and biting into Subway sandwiches bought during a lull a few hours earlier, when the paramedics' pagers simultaneously shrieked.
The town's only qualified Intensive Care Paramedic (ICP) Paul Reeves declared 'we've got a job' as his mentee and colleague Caitlin Little - a trainee ICP - tossed her half-eaten sandwich into the bin and ran for the door.
Inside the CRU's Toyota Fortuner, kitted out with advanced medical equipment and additional drugs, the radio came to life and a dispatcher in the Darwin communications centre gave an address and preliminary job details.
Within seconds the crew swiped out of the station gate in a clearly, well-practised routine.
A white-knuckled grip on the passenger side headrest in the back seat provides the only semblance of stability as the ambulance speeds towards a "one alpha".
One alphas are the highest priority cases and the responding crew has just two minutes from the triple-0 call being made to get on road with lights and sirens.
Lights flashing and sirens blaring, Paul puts decades of tactical driving into practice.
He's a veteran paramedic from the UK and has worked in trauma response in war zones and with tactical police all over the world.
"In some cases minutes really do matter and in cardiac arrest events survivability decreases 10 per cent every minute the heart has stopped," he said.
"So we try to shave off time during the emergency drive while making sure everyone inside and outside the vehicle is kept safe in the process."
We neared the town centre and approached a packed Uncle's Tavern, a bar where drinkers crammed into its courtyard barely bat an eyelid as the ambulance speeds towards it, before sharply turning down an adjoining laneway.
The paramedics slowed to scan the surrounds but saw no patient.
The crew's frustration because of incorrect or incomplete information was audible as they radioed the communications centre seeking confirmation of the address.
In the meantime, the Fortuner emerged at the other end of the lane and the paramedics spotted police lights a few blocks away.
It looked like an RBT but when we rounded the corner an ambulance - carrying two junior qualified paramedics - had already arrived.
General duties police, mounted police and detectives swarmed the scene.
There's no such thing as a quiet night for these outback cops.
Exiting the roundabout on to Leichhardt Terrace - a main drag that runs adjacent to the dry Todd River - there were people in the middle of the road crouched on the ground.
The CRU mounted a kerb and the paramedics grabbed their colour-coded medical kits from the boot and swung into action.
An aboriginal woman was curled in a foetal position on the road, her bloodied face to the bitumen. A heavily tattooed caucasian man in jeans and a T-shirt, who had been on his way home from the pub, cradled her as she groaned in pain, repeating 'you're all right darlin', I've got ya, stay with me'.
The woman, Ida (not her real name), was covered in blood. Her hair was matted and there were fresh wounds on her forehead.
But it was the deep gashes on her hands - not the palms but the tops - that were shocking. The exposed bone and tendons were crusted with gravel from the roadside. Police peeled the man - or who they refer to as "an enthusiastic bystander" - away from the woman while four paramedics began their assessment by torchlight.
He was briefly questioned by a female cop but he told her he didn't know the woman. He'd been on his way home in a cab when he saw her in the headlights and jumped out.
He then stood back and watched while paramedics tried to calm her, administer pain relief and assess her injuries.
Ida grew increasingly agitated and screamed in pain, before yelling "f**k off" as paramedics bandaged her badly injured hands.
"Her lower level of consciousness was probably due to a combination of both drunkenness and injury," Paul later told me.
"Being drunk is noted but then put to the side. However we remain alert to the fact that signs of something serious could be masked by drunkenness."
A few times Ida tried to move but couldn't muster the strength.
"Ida, Ida, relax down Ida. Relax. Keep your head still," pleaded paramedic Monique Barnett.
"We're going to give you something for your pain," she reassured.
In the periphery, people watched from footpaths and the shadowy, dry Todd River bed.
Police initially suspected the woman had been victim of a hit and run but there were no witnesses. Despite their doubts, paramedics applied a pelvic binder to her hips to prevent possible internal bleeding that could be the result of being hit by a car.
For about 10 minutes the four paramedics worked to stabilise Ida, enough to move her.
They put in an intravenous tube and gave her analgesia and sedation in the forms of fentanyl and Ketamine. Police helped the four paramedics lift the woman on to a stretcher and slide her into the back of the ambulance.
Caitlin, Monique and her crewmate Amy McCaffrey continued treating Ida as she cried all the way on the short trip to the Alice Springs Hospital.
"Ida, relax your head, relax. We're going to give you something more for your pain. Relax down, relax your head down. Well done. Good lady," Amy coaxed her.
Ida sobbed loudly in pain and agitation despite the increasing doses of potent analgesia.
"Relax your head Ida. You're doing very well. We want to help you," Amy reiterated.
"We're giving you something for your pain.
"Breathe in, breathe out. Something terrible has happened but you're OK.
"We're here to help you. Relax your head down. We know you're in pain. Here, here, put your arm down here."
A few minutes later the ambulance stopped, the stretcher pulled out and Ida was whisked into Bay 1 of the Emergency Department.
The paramedics had phoned ahead and the ED doctors and nurses were waiting.
She was wheeled in, the curtains drawn and Caitlin began debriefing the hospital team.
"This lady was found on South Terrace by a passer-by who believed she'd been hit by a car," she explained.
"On arrival she was responding but then stopped responding.
"On our arrival we found significant bleeding to the head and diminished air entry to the lungs however it was hard to assess on the road.
"We currently have a pelvic binder in situ and we have two bandages on her forearms due to wounds exposed on both hands which are quite deep with lots of gravel."
Amy then read out her blood pressure, heart rate and oxygen levels. They listed the drugs they had administered, before inviting questions.
Once the handover was complete, the bloodied paramedics moved out into the hospital hallway and debriefed with Paul on their treatment.
After every job they discuss what had worked, what hadn't and whether they should have done anything differently.
Shortly after, Paul explained Ida's injuries were inconsistent with a hit and run. Rather, he suspected her hand injuries were possibly defensive wounds suffered while protecting her face and head from being hit with a sharp object.
Despite being found on the road, a car may not have been involved.
A week earlier, Ida had been treated at the ED for stab wounds.
The next day the road remained closed after being deemed a crime scene and that evening NT Police Media released a statement appealing to the public for information.
NT Police has since told The Daily Telegraph they charged a 44-year-old man with two counts of aggravated assault and two counts of armed with an offensive weapon.
The man, who has a long history of family violence, most recently faced the Alice Springs Domestic Violence Court via video link on January 24.
Police successfully secured domestic violence orders to protect Ida and the man was remanded in custody. The case is due back in court on February 7.
The St John's annual report in 2016-17 revealed one in six Territorians used their ambulances, 000 received 51,970 calls, their ambulances transported 38,255 patients and they attended to 52,581 cases.
This is the life of a paramedic in the Northern Territory - it's tough, dangerous, exhausting, challenging, rewarding but ultimately life saving. These are the untold stories of courage, compassion, dedication, resilience and inspiration of a caring group of remarkable and selfless first-responders in two of the toughest towns in Australia.