Baby Giselle entered the world thanks to a telephone line

Paramedic helps deliver baby by phone

NSW paramedic Shani meets the baby she helped deliver over the phone, while reliving the dramatic emergency phone call with parents Thalia and Hussam Ali.

You never know quite what to expect with a triple-zero call to Sydney's ambulance centre.

Shani Buckingham, a paramedic of 10 years, listens in on her headset. The gentleman is a little bit excited.

"He said his wife was in labour. I asked a few question as per our protocol. Is she conscious? Is she breathing? Has she been having contractions already? How far apart are they?

Paramedic Shani Buckingham, visting the family of Hussam Ali, Thalia, their two boys Jan, 5, Isaac, 2, and newly born ...
Paramedic Shani Buckingham, visting the family of Hussam Ali, Thalia, their two boys Jan, 5, Isaac, 2, and newly born Giselle. Photo: James Brickwood

"Then the scene went chaotic. I could hear his wife in the background. She was in the bath. I said to him: 'Is that your wife having a contraction?' He said 'yes, about every five minutes.' "

In the recording, provided to the Sun-Herald with the parents' permission, she is screaming in agony.

Their conversation is captured:

Dad: The baby's coming out ... (screams)

Shani: The ambulance is coming sir. We are going to deliver this baby together now (more screams). We are going to keep the baby's head from coming out too fast. You are doing a great job there ... ask her to apply gently but firm pressure. Listen carefully to me Hussam, as the baby delivers, support the baby's head and shoulders firmly ... remember the baby is going to be very slippery, don't drop it...

Dad: Push hard, push hard (groans) ... the baby's coming out ...

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Shani: Nice and slowly, OK ...

Dad: We've got it, we've got it.

Shani: You've done a great job. Is the baby crying or bleeding?

Paramedic Shani, with Hussam Ali, Thalia, and newly born Giselle.
Paramedic Shani, with Hussam Ali, Thalia, and newly born Giselle. Photo: James Brickwood

Dad: Crying, crying, crying, it's crying.

Shani: You've done it. Well done, well done. Congratulations. The time of your baby's birth is 14.30, OK. Be sure that the cord is not wrapped around the baby's neck. Is it a boy or a girl?

Dad: It's a girl.

Staff at Sydney's ambulance control centre during a difficult call.
Staff at Sydney's ambulance control centre during a difficult call. Photo: Janie Barrett

On Thursday, Shani travelled to see Hussam and proud mum Thalia at their home in Liverpool for what was an emotional meeting.

Shani, cradling baby Giselle, said: "You did so well, so did your dad. The ambulance crew were jealous because we delivered you before they got here."

Thalia revealed she had visited Liverpool Hospital 30 minutes before she went into labour. "You aren't going to give birth now," she was told. "Go home, relax and have something to eat."

Raegan taking emergency calls at the Ambulance Control Centre in Sydney.
Raegan taking emergency calls at the Ambulance Control Centre in Sydney. Photo: Janie Barrett

At Sydney's ambulance centre, every time a call operator delivers a baby, they get a card pinned to what is called The Stork Board. There are about 30 cards on the board.

What is it really like at Sydney Ambulance Control Centre

On each desk at Sydney ambulance control, one of four centres in NSW, there’s a pole reaching up with two lights on the top.

A green light means the call controller is in the middle of a triple-zero call. A red light means things are getting heavy and assistance is required. When a new call alert sounds in the headset, it’s likely a cocktail of raw emotion is about to emanate from the other end. The callers display fear, confusion, frustration and, sometimes, anger.

The staff respond to about 100 calls a day, some of them with callers who are traumatised and very emotional.
The staff respond to about 100 calls a day, some of them with callers who are traumatised and very emotional. Photo: Janie Barrett

The looks on the faces of three controllers (pictured above) shows something of the ordeal faced during one call. A language barrier had something to do with it. The caller, in an emotional state, issued expletives to the person who was trying to help him before hanging up. An increase in abuse and threats to controllers has been recorded in recent months.

One of the multiple screens on the operator's desk shows the nature of a call. Lines in red type are the serious stuff. They’re the one’s where the ambulance has all the lights on and sirens blazing and might even jump a red light (if it’s considered safe) to get to you.

On Thursday, a day that “isn’t very busy” the list contains the following: shooting Central Coast; epilepsy; MVA (motor vehicle accident) hazardous; intentional o/d, abdominal pain; abnormal breathing.

Staff deal with births,  deaths and everything else in between. They take about 100 calls a day.

Sue has five screens in front of her. Her job is first to establish the precise location and contact numbers for the caller. She then establishes the nature of the problem - is the person breathing? Are they bleeding profusely? Do they have a history of heart problems? This is part of the Medical Priority Dispatch System which means ambulances are prioritised for the most urgent cases.

The control officer, who may be a civilian or a paramedic, then goes through a protocol giving advice depending on the diagnosis. A team of dispatchers then allocate the closest and right type of ambulance for the job while the call taker gets information.

"Mum's collapsed. I can't get her to respond. She's 95. She's kind of slouched backwards," one caller says.

Another call involves a 14-month-old baby with tachycardia and pneumonia who needs to be transferred between hospitals and may need oxygen on the way.

Then comes this: "She's 73, she's out the back, bleeding. She's having another seizure."

A 12-year-old at high school has fallen heavily and knocked her head.

At another high school, a 13-year-old girl is in incredible pain. She was discovered on the stairs outside.

An 80-year-old gent put his hip out trying on new shoes.

Another of similar age, with Parkinson's and a history of strokes, has driven home from a bowls club after his blood pressure went through the roof.

"She's 69. She's got blood all over her face," says another caller. The dispatcher calmly responds: "Is the front door unlocked? I am going to stay on the line as long as possible..."

Sue has had her share of hostile calls. "There's abuse and there's abuse," she says. "People handle stress differently and we understand that. Some 95 per cent of the public's great, it's just that small minority but it is getting wider now. I think they believe we are holding things up. Do you know what? If  they are compliant we can have that job in the queue within one minute, 20 seconds."

She tries not to take work home with her but there are a few calls lodged in the memory.

"Part of the coping mechanism is we have to finish the call and then go on to help the next patient. Sometimes you have a bit of a tear. You have to go for a walk. We have all got families. You do get affected by it," she says.

"Babies are always upsetting. The call taker buzzed me over because he was a bit upset. It was a seven-month-old baby, one of twins, and it was a cot death, it was SIDS. The mum was obviously very upset but the dad was doing everything that we asked of him. But then as the ambulance got closer, I think he realised that bubby was gone."

Visibly distressed, Sue continued: "It was just the change in his voice. The realisation ... it's upsetting, of course it is." She wipes an eye. That call was about two years ago.

The call takers are in it together. They prop each other up when needed. There's a table in the middle of the centre laden with chocolate cake, profiteroles and biscuits. A sign says: "Happy belated birthday Alaine".  Some bring in roast meals to share, there's fish and chip night. Friday was, according to the sign on the fridge, karaoke night out.

NSW Ambulance also looks after its crews, who sometimes go into threatening situations. If they haven't been in touch for a period of time an alert prompts the dispatcher to make a check-up call.

Tony Gately is assistant commissioner, director of control. He knows the form. "It's full on isn't it?

Explaining what happened during the triple-zero glitch two Fridays ago, he said control started getting calls for Victoria and South Australia. "We soon found out from the other emergency services and Telstra [which sorts triple-zero calls to the relevant emergency service] that there was some sort of difficulty.

"When Telstra was unable to get some calls put through to us, the system automatically sent them to police and fire which were then relayed to ambulance using a common electronic messaging system called Computer Aided Dispatch.

"There's a number of investigations going on so we have been asked to pull some information together so we can learn any lessons to build the robustness of the system. We haven't identified any adverse effects as a result of it."

Of the pressures of the job, he said there were a range of support services available to staff - right up to assistance from a clinical psychologist.

"Right up front now, when we are recruiting people to this role, we don't gild the lily at all," he said. "We will play them some of the calls where people have been more abusive. 'We can train you but we can't train the public' is what we say.

"There are the jobs where they help to deliver a baby over the phone or give instructions for CPR and they hear the patient has successfully been resuscitated. You just can't put a price on that."

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