When someone dials 000, rarely do they think about the process involved in having an ambulance and two paramedics arrive on their doorstep, prepared for the worst.

In all likelihood, their own health or that of a loved one is the only thing that matters in the world to them.

But after spending an entire night dealing with people who are in crisis mode, it's hard to compare one situation against the other. They all need help in their own unique way and they all need a paramedic.

My journey begins on a casual Friday afternoon at the Cairns Ambulance Station. I've arranged to go for a 'ride along' with the ambos, in the hope of witnessing firsthand what they do. The shift is expected to be a busy one: 6.30pm to 6.30am. Drunks, street brawls and vomiting all come to mind as distinct possibilities.

The station is where I meet my host for tonight, QAS regional operations supervisor and intensive care paramedic, Neil Noble.

The chiselled jaw and short blonde hair give Neil the affable nickname 'Buzz', after his striking similarity to the popular Toy Story character. That is, until you hear his rich South African accent.

"Running an ambulance station's like running a restaurant," he tells me.

"You've got to make sure people are happy and the client services are up and that everything works... and everything's to the client's satisfaction.

"We get to see an entire array of people. So on the one hand, we're handing over to specialist cardiologists with our cardiac patients, and the next thing we’re dealing with a drunken man on the road who’s swearing and carrying on."

Having been in the business since he was 17, Neil spent 30 years working as a paramedic in his native South Africa before choosing to settle in Brisbane and then Cairns two-and-a-half years ago.

The now proud Aussie (who still refers to South Africa as the 'homeland') loves life in the Far North with his wife Valerie, a flight paramedic, and their two young children.

"We support the Wallabies, much to the disgust of the South Africans, let me tell you," he quips.

"I've only been to the Great Barrier Reef once, but I tell you what, I was worse than an overjoyed Japanese tourist."

But all that banter falls away when it comes to saving lives.

His wise-cracking, jovial personality transforms into a wave of focus and professionalism as we get our first call for the night: a house fire at Mossman with multiple victims.

It sounds serious but Neil remains sceptical.

"Unfortunately, this particular area's known for its hoax calls," he says, as we speed along Sheridan
St in the ambulance support car.

Neil's gut feeling soon turns out to be right, after it's confirmed over the radio that it was a young boy standing outside the Mossman post office who made the call – with no fire in sight.

"It's frustrating. You can pretty much pick it with school holidays and public holidays, that sort of thing, the number of (hoax) incidents go up."

Our next stop finds us at Cairns Base Hospital's Emergency Department. It seems fairly quiet this early in the night, but it's a good opportunity to meet some of the paramedics under Neil's wing.

And that's where I meet advanced care paramedics Amy Craike and Sarah Myers. Both in their early twenties, it seems an odd choice of career for these young health professionals. But they have their reasons.

"It's probably just something different everyday I guess, and when you do get good jobs, it pays off for all the rubbish," explains Amy, 22.

"It's helping someone when they're in need. I think I've got two thank you cards in my time."

The diversity of the job is something that Sarah likes as well, with any day ranging from routine patient transfers to saving a life.

"We are welcomed into anyone's house just because we're paramedics.

"They don't know anything about us, who we are ... and we just get welcomed into people's houses because they need us.

"When you put it down to that, it is quite rewarding," she says.

The time ticks slowly away, as Neil and I follow the girls to their next job at a Cairns North apartment. A woman is suffering chest pains and needs help. As we arrive around 8.30pm, it appears the situation isn't as bad as first thought and Neil is quickly called away to a car crash in Portsmith.

Acting largely as an emergency backup in cases where patients need specialist assistance, intensive care paramedics must have a minimum of two to five years experience as an advanced care paramedic and a graduate diploma in paramedicine before they become fully qualified.

As we arrive on scene in the support car, a mangled blue Hyundai comes into view. Its front bonnet is crushed in and a driver side airbag has been deployed, while remnants of the car are strewn across the road. There's also a fallen traffic light post, with police and fire fighting crews on the scene.

It seems chilling enough to expect the worst, but it appears the car's occupants, a mother and child, are OK albeit a bit shaken up, and are treated for minor injuries in an ambulance already parked on the side.

And that's when it happens. The first serious call for the night. Head trauma. Bleeding. Yorkeys Knob. That's as many details as I know as we race over to the northern beaches.

Arriving at Yorkeys Knob Boat Club around 9pm, the patient, an older man probably in his 60s, is already being operated on in the ambulance.

His partner looks on worriedly and then I notice it. The blood. A dried pool of it on the ground. Confronting to say the least as I try to take photos of the paramedics 'in action'.

It's the worst possible outcome for what was a drunken night out with friends. The man's head is bleeding – a blood clot in the brain. However, it's exactly the kind of situation Neil is trained for as we swap the support car for the ambulance and make our way slowly back towards Cairns Base.

Advanced care paramedic Caroline Ryan is in the driver's seat, travelling at a slow speed in order to avoid causing any further head trauma for the patient. Meanwhile, Neil works frantically in the back, as he tries to get a catheter tube down the man's throat.

"You just get used to it, I suppose," she tells me over the stomach churning groans of the man in the back.

"It's just another job, which probably sounds terrible but you just get used to it."

As we pull in to the hospital, it's clear the night is getting busy for the emergency department. Five or so ambulances wait in the parking bays, all with patients who need a bed.

"Cairns gets so busy that we end up with ramping at the hospital – where the hospital's too full in the ED to take patients – and the ambulances will get lined up," Neil explains.

"That's frustrating in itself because it just limits our ability to respond."

Former Birmingham boy James Andrews, who grew up with two parents as police officers, paints a vivid picture of life as a paramedic and the motivation that keeps them going.

"You've got to be pretty unshockable and most of us are," he says.

"You spend 20 or 30 years doing this job, you see enough images in that 20 or 30 years to give you nightmares permanently.

"But I live in this community, my family live in this community, and that's a bit more important to all of us, I think.

"We love what we do."

The father-of-one also knows the toll it takes on the family unit.

"I've got a one-and-a-half-year-old daughter, and I kiss her every time I leave the house. I kissed her one morning and walked out that door, and an hour later I was telling a mother that her child was dead.

"It starts to rock your world the longer you do it."

As the night drags on, the variety each call out brings never ceases to amaze me. A 17-year-old who overdosed on LSD celebrating his birthday is the next eye opener. It takes five people to hold him down, including two police officers, while he is cuffed and then eventually injected with enough sedative to drop an elephant. It was hours before he returned to any sense of normality.

Then a wheezing toddler becomes our next port of call at around 4am, with a viral larynx infection known as 'croup'.

But the one final harrowing moment comes later that morning. As it approaches the end of the shift, Neil is called to a possible cardiac arrest at Redlynch. Arriving at the house, James and his offsider Kerrin are already inside, feeding oxygen in to the patient's lungs. The family is speechless, shocked at the series of events that have just unfolded as Neil assesses the situation and gets the patient on board the ambulance. But in among all the chaos, and the terrified looks and the feeling of helplessness, there's still something I can't help but notice.

Those eyes. Those goddamn eyes.

One staring open into the abyss of a white, sterile ambulance cabin. The other, half closed and unresponsive.

"At least he's breathing," I think, stealing a glance at the ECG monitor while nursing a spare bottle of oxygen.

The patient, body lifeless and a worrying shade of white, lies less than 30cm in front of me. To think a simple headache could turn into a full blown stroke. But you learn to expect the unexpected in a job like this.

A relative, most likely the wife or sister, sits up front, trying to maintain a false sense of calm. Her right fist remains tightly clenched hoping for a good outcome. We all are.

It's now approaching 7am on a Saturday morning, the 13th hour of a long night shift spent witnessing amazing feats of heroism. Most people would still be sound asleep after a hard week at work, blissfully unaware of the drama unfolding as we rush towards Cairns Base Hospital.

Not so for the paramedics of the Queensland Ambulance Service.

They've got a life to save.

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