BONFIRE night is traditionally one of the busiest nights for Ambulance crews across East Lancashire. But as well as responding to emergency calls, crews also have to face aggression, violence and intimidation. And they are frequently used by the general public as a "taxi service". Reporter CAROLINE INNES spent a night shift with a Nelson ambulance crew to see the full extent of the problem.
THE sign in the ambulance reads: "People who are abusive or violent towards ambulance staff will be arrested."
It hangs just above the stretcher where patients who have been picked up by the crew would lie to receive what could be life-saving treatment.
Paramedic Dean Hebden, explains to me some of the problems he has faced during his ten years in the service.
Dean, 46, who lives in Rossendale, said: "Violence and abuse is part of the job and, unfortunately, every single paramedic in East Lancashire will have a tale to tell. If someone decides to attack you, there is nowhere to run in the back of an ambulance.
"I have had someone trying to stab me and another crew member with a fork after we had been called to help him after he collapsed."
Out with Dean, on his first official night as a paramedic is 48-year-old Paul Roberts.
Between emergency calls they are able to fill me in on some of the hairier moments.
Fellow paramedic Lou Sherriff, 28, had been called to save a man who had slit himself open with a knife. The man spat blood at her. Then he told her was HIV positive. He later admitted he was lying.
Paramedic Paul Ellis, 24, was punched in the face by a patient he had delivered safely to casualty while paramedic Debbie Ivason, 32, received death threats.
My first job with Dean and Paul at the station at 4pm is to transfer a woman with an abscess to hospital.
A few minutes into the journey and we receive an emergency call to Clitheroe Road, Brierfield, where an 86-year-old woman, who suffers with angina, has collapsed. There is no time for a breather, as at 5pm we are called to help a 75-year-old woman who has fallen. Another crew is closer and we are stood down.
Just as we arrive back at the station at 5.45pm, a call comes in to go to Manchester Road, Nelson, where a man has had a fit.
Our next job is at 7pm when we are called to Church Street, Nelson where a young woman is writhing on the pavement with severe abdominal pains.
At 8.45pm firecrews request the ambulance to attend a fire in a flat in Edgeworth Grove, Burnley. They have rescued occupants from the flat and feared they may have suffered smoke inhalation.
At 9.15pm, we head back to the hospital to restock on gas and air used by patients.
At 10pm, an 11-year-old boy is taken to Burnley General with complaints of abdominal pain and a pain in his chest. Just half an hour later ,a call goes out to treat another 11-year-old boy who is at a bonfire in Ringstone Crescent, Burnley.
It was said that he had been jumping over the fire and gashed his leg.
At 11.15pm, the last job of the shift is a 20-year-old man from Burns Street, Nelson who has had severe vomiting and a headache.
At 1am, we are back at the station. The crew has been on the go for 13 hours. And it's almost time for home.
But not before Dean tells me of his frustration at the way ambulances are treated.
At a cost of £85,000 per vehicle an ambulance is the most expensive taxi some people have ever called for - but it happens on a regular basis.
Dean said: "We have had lots of instances where we have been called to take someone to hospital and it turns out that they live just across the road from it. When I was filling in their paperwork, I watched them sneak out of casualty and run off home.
"I have also been called to a phone box in Burnley where a man had called us because he had hit a wall earlier in the evening and when he was sobering up he realised his hand hurt.
"I asked him why he had called an ambulance and he said it was because he didn't know any taxi numbers."
"I once went to a girl's house who had called us because she hadn't had anything to eat all day and didn't know how to microwave a pizza. After giving her a talking too we cooked the pizza for her and left."
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