Goodrem is the ACT Ambulance Service's acting emergency operations manager, racing across the Canberra Avenue bridge to back up crews treating an unconscious, septic 79-year-old man in Harrison.

Shallow breathing. Dementia. History of stroke. The elderly man's medical history flashes on the mobile data terminal, which tracks the different cases ambulance crews across Canberra are attending throughout the night.

He's not well.

Observations are underway on arrival but things are moving quickly. Four paramedics strap the man onto a carry sheet and move him through the front door.

His wife leans down and kisses him on the head, before he's placed onto a stretcher and covered in a blanket, hidden from the foggy chill.

In one swift movement he's swallowed by the ambulance and hooked up to an IV line, before the vehicle disappears into the night.

"We've had some busy nights lately, we've done 80 cases in a shift," Goodrem says.

"All your crews are busy all night."

It's hard to imagine walking into a room and making what can, at times, be a life-changing decision on the spot.

"You might have a motor vehicle accident, you might have three crews there dealing with six or seven patients," Goodrem says.

"You're there with your partner, trying to figure how who you're going to treat first; that bonds you."

Tonight's Friday night shift is relatively calm. But some jobs, mostly awful, wedge themselves in a paramedic's memory.

As the car weaves through suburban Belconnen between cases, Goodrem returns to one he'd rather forget.

Pointing to a tree up ahead, he retells the aftermath of a speeding motorcyclist crashing into its trunk.

"He was drinking, jumped onto the bike about 2 o'clock in the morning, flogged the guts out of it at high speed and up here, see where he hit the tree?" he says, pointing.

"I can still see the job: every time I did compressions blood was coming out of his mouth."

Goodrem doesn't usually tell "war stories": "I deliberately push them out of my head".

It's easier said than done. When cases are pouring through the system, crews have to arrive at the next scene with a clean slate.

"It can be really difficult. Some days it's easier than others. When I started I was lucky to get seven years out of the guys," Goodrem says.

"They'll have a really difficult job, it can be really confronting...and they get back in that ambulance and head to the next job."

One of the Dickson crews is required to do just that, not long after the Harrison case.

And it's a scary situation for any parent: a small child having a fit.

At 3.50am it's a race to Watson. Goodrem says convulsions are more common among young children than some might expect; small bodies are less able to compensate for a rising temperature.

"I remember my son having a convulsion and it was just as scary as anything," he says.

"We'll see how good this kid is, I might have to get my hands dirty."

The ambos race in to check on the two-year-old boy. He's no longer shaking. Luckily, a few minutes later, cries emerge from the lounge room.

"Seizures are dangerous and awful but the underlying medical condition is the thing that now needs to be addressed," Goodrem says.

The boy has a temperature and rattly breathing - he might have a chest infection. Regardless, he's taken to hospital.

The boy's mother scoops up her little bundle of golden curls and carries him into the ambulance, a forced calm across her face.

No case is ever about one sick or injured person. The impact of a medical condition or injury can rattle a worried partner, parent or paramedic.

The demands of paramedicine itself - the shiftwork, the pressure, the psychological impact of a "war story" - can also impact family.

"Sometimes you do take stuff home," says Goodrem, talking about resuscitating a child a few years ago.

"That really knocked me about. I went home shattered halfway through the shift so, you go home to your wife broken."

Goodrem, who has two sons, 15 and 22, was once told by an experienced trainer, to "get the nervousness out of your system you need a bad job under your belt".

A session of counselling or a debrief around the ambulance could also help.

"Sometimes your cup's full and you don't have much reserve left to cope with stuff so, you're just scraping through," he says.

"Then other times you can hold a lot more and you'll look after your partner whose cup's a bit full."

Alcohol and drugs can also complicate treatment.

Just before 1am we head to the Sobering Up Shelter at Ainslie Village. It's not an uncommon stop for a Canberra paramedic.

The smell of booze wafts off the 45-year-old woman. She's drunk and has taken three anti-anxiety pills. The staff are worried.

The woman can stand but she needs help walking to the ambulance, where she's laid on the stretcher and wrapped in a blanket.

Goodrem says the tablets, like alcohol, act as depressants. Combined the two have wrecked havoc with the woman's central nervous system, each making the other more powerful.

But she's walking and talking and understands she needs to be assessed at the hospital.

Next it's north to Page where a woman with Down syndrome and epilepsy has been found on the floor of a care house, conscious, with blood on her face.

Two Belconnen paramedics file into the house to mop up the blood and check the seriousness of the cuts.

Together, they slowly place the woman, aged in her 40s, in a wheelchair and carry her down the stairs, before helping her onto a stretcher, talking the patient through their actions to keep her calm.

One paramedic clutches the woman as the stretcher is steadied: "are we having a cuddle?" she gleams. The woman is wrapped in a blanket, strapped in and pushed into the ambulance.

It's a small gesture but one that can make a real difference during what can be a stressful or terrifying ordeal.

Sometimes just being there can be life-changing.

"I've been with people when they're having the best day of their life and I've been there when they're having a really bad day," Goodrem says.

"I've also been there when they're having their last day. You can be the last face they see."