Trauma day in...day out

North Yorkshire's roads are the most dangerous in the country. The death toll per head of population is greater here than anywhere else: so far this year, 82 people have lost their lives, already more than the 76 who died in 1999.

The county has 6,000 miles of roads, ranging from winding country lanes to roaring motorways. On these travel everyone from holidaymakers to motorbike enthusiasts, from commuters to mums taking their children to school.

Too many of these travellers fail to complete their journeys. On average, someone is killed on North Yorkshire's roads every four days. In the last week six people died in a multiple crash on the A1(M), and an elderly couple lost their lives when their car hit a van on a B road near Helmsley.

We are all shocked by these stories and statistics. But those charged with dealing with the immediate aftermath face traumatic scenes, week in, week out.

The police, fire and ambulance services all attend serious road traffic accidents. They work closely together, often in difficult conditions, to save lives.

Although they become hardened to scenes of roadside devastation, these men and women would not be human if it did not affect them.

Sergeant Nigel Atkinson has been policing the roads for 14 years. His patch covers York and Selby, encompassing roads such as the A1, M62, A64, A59 and A19.

He says no training can prepare you for the appalling mess of a road crash. "Largely, that training comes from experience. I don't think you could prepare anybody to deal with the trauma that comes with the job."

Does he feel apprehensive when he is called out to a serious accident? "I don't think it's apprehension, I think it's disappointment. The road policing force is geared up to prevent death and injury. It's always disappointing when that occurs."

At the scene, the training and professionalism kick in. "There's such a demand on what we have to do when we get there. We almost go on to automatic pilot.

"There's not only the life saving and first aid activity, we have to preserve evidence and interview witnesses."

That evidence will be crucial for the specialist police team which investigates the cause of serious accidents. They are the subject of Crash, a Channel 5 documentary broadcast on Monday nights.

"It's perhaps after the event that you reflect on what you have been to," Sgt Atkinson explained. "This can be almost more traumatic than what you have been on in the first place."

Talking it through with colleagues does help, he says. And the police can always turn to the in-force welfare department, with its trained counsellors.

Sgt Atkinson has become hardened to the devastation. Having attended, he guesses, 50-plus fatal accidents "they tend to make less of an impact". But he admits you can never get used to breaking the news to a loved one.

Does he take his job home with him? "My initial reaction would be no, you don't, but obviously you do. You must do.

"I don't think anybody could be immune and not take it home."

John Pawelec is educational and development manager at Tees East and North Yorkshire Ambulance Service. He is also an operational paramedic, a job he has been doing for 22 years.

"It's said that you become hardened to these things but I'm not sure.

"Whenever you go to an incident that involves loss of life you think how terrible it must be for the relatives.

"Sometimes I am taking people to hospital, and I think somewhere there's a relative sitting and waiting and thinking, 'he's a bit late', and you think how horrible it must be for these people."

At the scene of an accident, a paramedic has to determine who is treated first, stabilise the injured, and prepare to take them to hospital. Only afterwards is there time to think. "We always offer counselling," Mr Pawelec said. "I went to the accident on the A1 - it was dreadful. There were four crews at that, they were all offered counselling.

"Everyone has their own way of dealing with it. Some want a quiet period of reflection. Some find it helpful to talk to their colleagues about what they saw, what went on, what they had to do.

"Some talk to professional counsellors.

"The worst thing you can do is bottle it up and keep it to yourself."

With 13 years' experience as a firefighter first in Harrogate then in York, Station Officer Cecil Pugh has more than enough experience of road crashes.

Between January and August this year, the North Yorkshire Fire & Rescue Service attended 340 road traffic accidents and freed 90 people. "We probably do as many serious road traffic accidents as we do serious fires," he said.

He stresses that everyone works as a team at the scene of a crash. Fire officers isolate any potential sources of fire as ambulance crews assess the injured. Using bulky hydraulic cutting equipment, fire officers can free any casualties.

This can be "extremely protracted, depending on the nature and the severity of the impact".

"It's very difficult to prepare yourself for some of the things you come across," Station Officer Pugh said. "They are quite disturbing and traumatic on occasion."

Again, counselling is offered, but "generally most firefighters prefer to talk about it amongst themselves".

"You do cope with it. You have to cope with it to do the job."

All three men say the sights they have seen make them more aware of dangerous driving and its consequences.

Paramedic Mr Pawelec said: "I have just driven up the A1 this morning and seen people driving at ridiculous speeds in misty and damp conditions, and thought if they needed to stop suddenly, they wouldn't be able to.

"Some of these people who hurtle down our motorways at incredible speeds - if they saw what ambulance crews have to deal with I am sure they would slow down."

Sgt Atkinson, who has to put up with flippant comments from motorists he stops for speeding, echoes that sentiment. He said: "If you think about the most gruesome murder or most painful deaths you are thinking about something similar to what is happening relatively commonly on Britain's roads.

"The next time you are in a rush to get to the dentist and are driving in excess of the speed limit, or trying to overtake a slow vehicle, that just might be the trigger that ends your life or someone else's."