As it happened: London roadside emergency

Key points

  • BBC News reporters joined London ambulance paramedics to get an insight into a typical day on the city's roads, while we also looked at what happened in the control room.
  • It was a relatively quiet day on London's roads with about 65 call-outs and no life-threatening injuries treated. On a typical day, there are an estimated 100 casualties.
  • The capital's ambulance crews and paramedics treat the majority of those injured at the scene but take some of them to hospital.
  • A live map of call outs to collisions and road accidents across London was compiled.
    0708: Adrian Brown

    Every day, London's ambulance service answers dozens of emergency call outs to road traffic collisions across the city.

    live map showing accidents across the city

    Throughout 6 December, a team of BBC journalists will be alongside ambulance crews as they deal with a typical day on London's roads.

    As the day progresses we will be plotting these incidents on a live map as they occur.

    We want to get a sense of the scale of road casualties in the UK. Government estimates put the annual number of road casualties in Great Britain at around 730,000. That works out at about 2,000 killed or injured each day.


    Last year, on average, five people died every day, while 840 were sufficiently injured to go to hospital. The rest were had minor injuries.

    We can't cover the whole country of course but London represents a big enough area to be reasonably representative.

    On a typical day, it's estimated that there are 100 road casualties in London. Dispatched to around 70 emergency calls to road collisions every day, the city's ambulance crews and paramedics treat the majority of those injured at the scene but take some of them to hospital.

    Our team of reporters will be filing reports on each incident as it unfolds, giving you a detailed account of how the capital's emergency services deal with the daily toll of road casualties.

    You'll be able to follow them on this page or on twitter using the hashtag #crash24.


    BBC reporter Adrian Brown is at the London Ambulance Central control room monitoring 999 calls as they come in. BBC reporter Lucy Rodgers is on the road with paramedic Shaun, BBC reporter Dominic Bailey is out with paramedic Steve and BBC reporter Debabani Majumdar is with another paramedic called James. We are not using the full names of the staff working for the ambulance service.


    Debabani and James have already been called out to the scene of a collision between a car and a cyclist. The cyclist, who wasn't wearing a helmet, has a swollen and bruised ankle. James, the paramedic, says the cyclist was lucky to escape without suffering any head injuries.


    Lucy and Shaun's first call is out to the M4, where they are weaving through long queues of early-morning commuters to reach what they have been told is a collision between a car and a lorry.

    Ian Ramsdale

    tweets: Got our first call. A crash on the slip road of the A13 with the M25. 21-year-old, car facing wrong way on the carriageway #crash24


    Dominic Bailey's first call of the day, along with paramedic Steve, is responding to a reported motorbike accident in Bromley. However, the call is cancelled as they are en route. They are told an ambulance is already at the scene and will take the patient to hospital for treatment. There's just enough time to fill in the necessary paperwork before another call comes in for a collision between a cyclist and a car in Bexleyheath.

    Ian Ramsdale
    Ian Ramsdale's Hi-Viz London Ambulance jacket marked Press Observer

    tweets: Body armour and hi-viz fitted. New tape in camera. I'll be following Peter the paramedic on his shift #crash24

    0752: Dominic and Steve

    Bexleyheath cyclist, 63, being treated in ambulance. Had been on way home from work when accident happened at junction with main road. Neighbours fetched his wife who is a bit shaken. She says he's still having physiotherapy after being knocked off his bike last year. Police at the scene taking statements.

    London Ambulance

    tweets: On avge there are around 7 deaths a day on Britain's roads. Pls be careful in rush hour traffic this morning #crash24

    London Ambulance

    tweets: Gordon and @marcashdown from the BBC head out with Chris Doyle #crash24

    Mark Ashdown with Chris Doyle from London Ambulance

    The BBC's Adrian Brown is in the control room of the London Ambulance Service. He's already heard all the calls to which our reporters have been dispatched as well as dozens of others, including a car that hit bollards on the A13.

    London Ambulance

    tweets: One of our fast response cars is on its way to Orpington. Reports of a pedestrian hit by a car #crash24

    0816: Lucy and Shaun

    Arrived at lorry and car crash on the M4. An ambulance crew is treating a Hungarian lorry driver for shock. He tells them he is shaken up and his heart is racing. The ambulance is swaying from the high volume of motorway traffic racing by as they inform him he needs to go to hospital for checks.


    The BBC London's Ian Ramsdale, who is accompanying paramedic Pete, is on the scene of the crash at the A13 with a young man trapped in a car. The fire brigade will have to cut the roof off the car to free him. The driver is complaining of lower back pain, but has no other apparent injuries.

    Four fire engines have arrived. They're going to remove the roof of the car so he can be lifted out. The windscreen has been cut and the fire rescue unit has arrived. The doors are being cut off, while the patient is being held steady in the driver's seat.

    Marc Ashdown, BBC London News

    tweets: First job. Cyclist and lorry in finchley. Very fast up the A5. Looking icy which doesn't bode well. #crash24

    0830: Lucy and Shaun

    More on the M4 crash. Keith, attending the scene for the Highways Agency, says this sort of two-vehicle accident is typical at rush hour in high volumes of traffic. Lots of lane changing close to junctions and the usual outcome is a minor injury.


    Ian and Pete say the driver has been safely removed from the A13 crash. Peter, the paramedic, is seeing him into the ambulance. The fire service is cleaning up the slip road that is still closed and the Highways Agency is clearing up the A13 so that it can be reopened. Ian sent this picture of the car.

    A car after passenger was removed
    0858: Dominic and Steve

    Cyclist in Bexleyheath had back pain, hurt shoulder and elbow and is being taken to Darrenth Valley General A&E.


    Adrian Brown in the control room gives us an update on a call out to Wembley. Paramedics at the scene say that they have been told that a 16-year-old girl was crossing the road talking on a mobile, a cyclist gave way so that she could cross, but a van behind didn't give way, hit the bike and the bike hit the pedestrian. The girl was taken to Northwick Park Hospital. She did not have any physical injuries but had suffered shock.

    0911: Marc and Chris

    On the scene in Finchley. Cyclist quite bloody but nothing serious. Knocked off his bike on main road. Traffic very bad already. Shows the knock-on effect of accidents on the road network.


    This live round-up of a day with London's ambulance service is part of a BBC series looking at accidents on British roads. Our coverage includes an interactive map showing the 36,371 deaths on Britain's roads between 1999 and 2010. You can type your postcode into our search box and generate a local snapshot of all the fatal road accidents in that area over that decade.

    Marc Ashdown, BBC London News

    tweets: #crash24 rush hour easing up a bit so things should quieten as people reach their desks.


    BBC London's Ed Davey says paramedic Rob has told him that he has only seen three fatal traffic accidents in his 10 years on the job. It's a reassuring reminder that - due in part to the quick response of the emergency services - most of the accidents on London's roads involve injuries that people recover from.

    London Ambulance

    tweets: We've received 4 calls to a collision in Wapping. Reports are that a van has hit a pedestrian #crash24

    0939: Emma and Rebecca

    The control room has instructed us to head for SE16, Rotherhide. No incident as yet but it's classed as an accident black spot and HQ want to make sure the area is covered.

    0941: Emma and Rebecca

    We've got a call, blue lights on. We're off to Tower Hamlets. This incident involves a van and a pedestrian. An ambulance has already arrived on the scene - we're still on our way.

    Dawn Victor-Tully

    tweets to ask: Where are the 2 ambulances & paramedic car going to in hornchurch? Just went flying past me. #crash24 @Ldn_Ambulance

    Spencer Marks

    tweets: Getting ready for work, watch out on here #crash24 for coverage of today's shift with @Ldn_Ambulance

    0958: Ed Davey BBC London

    You really do get all over town in this job... just 9.45 and we've already been through north, south, east and west London.

    0958: Debabani Majumdar BBC News

    In the last three hours paramedic James and I attended one incident and received one cancelled call, which he says is about average for the morning rush hour.

    London Ambulance

    tweets: "Going to an incident where a car has gone into a wall in Greenford. Reports of a person trapped. #crash24" and then six minutes later "Greenford incident - adult male conscious and breathing and is out of the car #crash24"


    To provide a snapshot of the scale of road accidents in London, and the pressure this puts on emergency services, we have a live map of road accidents across the city today.

    1020: Emma and Rebecca

    Just a quick update following our Tower Hamlets call. The ambulance had a three-man crew - two paramedics and a student. The student will work under close and constant supervision - its such a hands-on job that the "real life" interaction is invaluable. It fills the gaps of what can't be taught in the classroom.

    1021: Dominic and Steve

    The radio is quiet for the moment - no calls. The lull between the morning rush and lunchtime. Making the most of it to have a coffee break at Lewisham hospital. Steve says it seems to be a quiet day all round given the number of calls logged today.


    In a week when BBC News is focusing on the death toll on Britain's roads, we look back to the country's first fatal car accident. It happened on 17 August 1896, an era when there were far fewer cars on the road than nowadays. Labourer's wife Bridget Driscoll, 44, was walking to a fete in south-east London when she was struck by a car travelling at a reported speed of 4mph, which was described as a "tremendous pace" at the victim's inquest. The BBC's Andrew McFarlane recounts the whole tale.

    Paul in Chelmsford

    emails: Considering the number of vehicles on the road in rush hour, isn't it a miracle that there are so few serious incidents?

    Carlton Reid on Bikebiz

    writes: A BBC reporter said a cyclist who injured an ankle should have been wearing a helmet, although there was no information given on how a cyclist should wear a helmet just above the foot.

    London Ambulance

    tweets: Re: Wapping incident involving a pedestrian & a van @ 9.24am. The lady has been taken to hospital with an injury to her right ankle #crash24

    1029: Debabani Majumdar, BBC News BBC News

    Rushing to the first call in Chalk Farm. Doing 90mph and zipping through traffic made me feel a bit queasy. Paramedic James says he had to pass a three-week special driving course for the job. And it's not easy to pass.

    1037: Lucy and Shaun

    After a quick trip to an ambulance service training centre in New Malden, the blue lights are back on and we're speeding north to Chiswick, off to a car and motorbike collision.

    1038: Adrian Brown BBC News, in London Ambulance Central control room

    I'm looking at the traffic cam from the control room. In Chiswick, a man is down on his face, with a motorbike on its side. A biker is bending over him and talking to him. Meanwhile, traffic is continuing to drive past within inches of the man's head. Unreal. A lady comes over and is giving assistance. Someone has put a red coat over the man. But the cars still haven't stopped, driving by at a rate. A lorry roars by within feet of the man's head. The control room asks for urgent police assistance. Still watching on the screen, I see a paramedic arrive. She uses her car to block the road so she can safely kneel down by the patient, but the cars are still driving around them - they're not stopping.

    London Ambulance

    tweets: "Ambulance crew on their way to a collision involving a motorbike in W4 #Crash24" and seven minutes later "The first of our staff on the scene at RTC in W4 #Crash24"

    1040: Dominic Bailey BBC News

    Having a look around the kit carried in these fast-response cars. They are pretty much packed with what you'd find in an ambulance. This ranges from the ambulance first aid kit, with defibrillator, to a kit for infectious or unhygienic patients. There's also a suction pump for clearing airways, hazardous area kit and a handy little drill for getting fluids directly into bones when there is no intravenous access. It doesn't hurt, apparently.

    Matt Kendall

    tweets: It's carnage out there already and it's only 10:30am. If this doesn't support a 20mph limit, I don't know what does. #crash24


    The BBC's Adrian Brown tells us from the control room that there are now two ambulances at the scene of the accident in Chiswick and police have taken control of the traffic situation. It turns out the patient is a woman, rather than a man, and she had gone over the top of her bike. She's got an "isolated" leg injury and is safely in the back of the ambulance.


    A reminder that it's not always road accidents that cause the delays on our roads. BBC Radio 2's traffic presenter Lynn Bowles has just given her half-hourly round-up and none of the incidents reported here are causing any major hold-ups. Her focus, in London at least, is on a long queue northbound towards the Blackwall Tunnel, which has been caused by a breakdown. You can contact her and the BBC traffic team on 03700 100200 anytime that you are in a position to provide information on an incident on the roads.

    Adam Coffman

    tweets: aghast to read that drivers did not slow down after someone was lying in the road, utter disgrace #crash24

    1126: Emma Lynch BBC News

    During quiet times Rebecca, the paramedic I'm with, generally reads newspapers, books or magazines - anything to keep her alert. It can be difficult to pass the time, especially as you can't really go far from the vehicle.

    1116: Dominic and Steve

    The general impression is probably that when you call an ambulance, it leaves the station and goes to the scene. There's something reassuring, like bobbies on the beat, about knowing these teams are out there already cruising around waiting for the call. These fast-response cars can clock up about 60-70 miles a shift, up to 100 if they are part of hazardous area response team which splits London east-west.

    Adrian in Eltham

    emails: @ Matt Kendall 10:53, you assume of course that speed was the main factor in these incidents rather than careless driving.


    Another update from the BBC's Adrian Brown in the control room. An accident has been reported involving a car and a pedestrian in Earls Court Road, which is one of London's busiest roads. An ambulance is on its way.

    1133: Emma Lynch BBC News

    The BBC's Emma Lynch, who is taking photographs while she accompanies paramedic Rebecca on her shift, sends us this picture from an earlier incident. A woman who was knocked down had her blood oxygen and pulse monitored in the back of an ambulance. It's a quick but important check.

    A foot
    1137: Dominic and Steve

    Lights and sirens on. We're suddenly up for a call to a crash between a car and a lorry in Becontree - about 10 miles away. Two minutes racing through high street red lights and we're stood down as another response car is closer to the scene. Rush over, colour returns to my knuckles and we're back to patrolling.

    1141: Emma and Rebecca

    And another call, this time to Dagenhan. It's an elderly woman trapped in a vehicle following a collision with a lorry. Blue lights, on to the A13 and on our way.

    1143: Debabani Majumdar BBC News

    Paramedic James has clocked up 75 miles since the start of his shift at 5am, and 50 miles since 07:00 GMT when we started off from the London Ambulance Service HQ in Waterloo.

    Adrian Brown BBC News, in London Ambulance Central control room

    On the A13, there's another incident I can see here on the control room screen. A badly crunched car is at an angle with the bonnet sprung open. The nearby ground is scuffed up and I can see liquid, possibly from the car, on the road. The female driver is out of the vehicle and safe. There are no life-threatening injuries and I can count a dozen firemen there, just in case.


    BBC photographer Emma Lynch, who is accompanying paramedic Rebecca, sends us another image, this time of a cyclist receiving treatment by an ambulance crew after he was knocked off his bike and grazed his leg.

     cyclist receiving treatment
    Jon Irwin

    tweets: @BBC_HaveYourSay re:Adrian in Eltham #crash24 careless driving/going too fast, slower speeds allows drivers to stop/avoid collisions

    Charlie Brindley

    comments on the BBC News Facebook page: Perhaps all ambulances crews should take lessons from the way medics operate in Afghanistan and funding for more Heli-Med aircraft and crews.


    Another quick update from the control room. Three cars have been involved in a crash in Shooters Hill, south-east London. A paramedic is on the way.

    Emma Dufton

    comments on the BBC News Facebook page: had to have paramedics out on Sunday nite, and i got to say a huge thank you to them they were so nice, kept me calm kept me talking and i felt totally safe in their hands, i was terrified thank you and to the guy on 999 stayed on the line with me till the paramedics got to me


    BBC London's Anjana Gadgil joins the team on the road monitoring London Ambulance Service's response to accidents. She has been teamed with paramedic Martin and tweets she has her stab vest on and is waiting for the first call.

    1227: Debabani Majumdar BBC News

    Paramedic James, who on a regular day is called to at least six incidents in five hours, says it has been quiet. This morning we have been called to one incident since 07:00 GMT. On a cold day like today you are mostly sat in a car reading newspapers, he says. He also calls his family because his two children are sleeping when he leaves home at 06:00 for a 07:00 start.

    Jeff Dalmer in Cardiff

    asks by email: Why aren't all response vehicles GPS'd up so only the closest free vehicles are dispatched to where required. Last update (11:37) about a call picked up 10 miles away, but within 2 minutes another patrol was closer, why run around like headless chickens when some thought can ensure quicker response times?

    Kaz in London

    emails: RE: 20mph speed limit, its not the speed thats the problem, its more to do with awareness and driver error. Most of these incidents occur during rush hour and quite often traffic is moving at 20mph or less anyway!

    1233: Adrian Brown BBC News, in London Ambulance Service Central control room

    It's calmed down a bit here now so I've been given a quick rundown on the technology that the ambulance dispatchers use to get crews to incidents. Dispatcher Andrew has three screens on the go - one that lists all the calls that come in, a second special mapping screen and a general admin screen.

    CAD, the computer aided dispatch system, is a large blue screen divided up into columns and rows. It lists every 999 call as it comes in. They're sorted according to the type of incident. The ones we're interested in are the ones labelled "traffic". Each call is also graded for priority: Red1 and Red2 which are life-threatening or potentially life-threatening calls; C1, C2 which are serious but not life-threatening; and then "not immediately life-threatening". Red calls have to be responded to within eight minutes, C1 within 20 minutes, C2 within 30 mins. Seven out of the 20 call-outs today so far have been Red2 though, fortunately, none have proved to be life-threatening.

    1242: Adrian Brown BBC News, in London Ambulance Service Central control room

    So how do the paramedics get to where they need to in London without unnecessary delays? Dispatcher Andrew has an impressive online map in front of him. It displays where every ambulance is in London. When a call is selected, the map zooms into where the call has come in. Andrew can then work out which ambulance is the nearest, and communicate over the radio system however many units are needed. Handily, the map also shows the nearest petrol station in case any crews need to fill up, as well as the nearest hospital.

    1248: Ed Davey BBC London

    Rob, the paramedic I'm travelling with, reveals the Volvo xc70s they drive need servicing every eight weeks because of the "battering" they receive. Brakes, in particular, get worn out quickly. Having seen the way Rob shifted it from Aldgate to Kilburn earlier, I can believe it.

    1250: Debabani Majumdar BBC News

    Last year was the busiest year for London Ambulance Service. There were 28,400 road accidents and October was the busiest month. This year July has been the busiest (so far) with 2,630 road accidents.

    1307: Adrian Brown, BBC News, in London Ambulance Service Central control room

    Just been watching, on the video screen, a woman hobbling into the back of an ambulance in Knightsbridge, helped by a member of the London Ambulance Service. She had been getting treatment by the roadside. Two police bikes are there. Traffic is filing past.


    Adrian Brown has sent us this image from the London Ambulance Central control room.

    Scene from London Ambulance Service Central control room
    1314: Debabani Majumdar BBC News

    Heading to an incident in Bounds Green, north London. Reports of a motorbike in a road accident, it's a man aged 30. No other details yet. Busy road ahead and cars are trying to make way for us, driving at over 100mph on the North Circular Road.


    tweets: I think the law should be changed so that you have to pass EMG vehicles or scene of incident slowly or move over like in USA #crash24


    Earlier, the BBC's Emma Lynch and paramedic Rebecca arrived at the scene after a car and lorry had a side-on collision.

    A car after a collision
    1320: BBC London TV reporter, Marc Ashdown,

    tweets: Latest update on #crash24 on bbc1 at 1330. Going live in the control room.


    tweets: Women in labour don't really need an ambulance in general. Bus or taxi will normally do. Hope all are enjoying #crash24

    1320: Emma and Rebecca

    Racing through East End traffic, blue lights and braced for speed bumps.

    Rebecca speeds through traffic
    Andy, in the UK,

    emails: How can the ambulances justify the claimed 90mph response? It's irresponsible anywhere, and especially in an urban environment. They need to remember that not everyone will see or hear them and it is only a courtesy and not the law that the public give way to them.

    Louise Raynham, in London,

    emails: People never quite believe when I say that I see at least one accident a week during my total 125-mile commute. Whether I'm in them or just observe them, it's at least one. If I don't see one in one week, I will see two the next.


    The BBC's Debabani Majumdar arrives at an incident involving a biker in Bounds Green, north London. She says the man, who works for a courier service, came off his bike in the middle of the road.

    Simon Cook, in Harlow,

    emails: Speed is always a factor as if nobody was moving there would be no crashes. We must accept this is a fact and look at other ways of reducing accidents. We need bigger gaps between cars, concentration is another issues, texting and drugs are a definitive danger! Speed cameras and discussion on speed is a distraction and just used for revenue. We need more traffic police to stop and educate people who text and travel too close to the car in front and better road surfaces.

    Katherine Dixson, in Kinver, near Stourbridge, West Midlands,

    emails: In the course of a half-hour journey this morning, I noticed four or five drivers on hand-held mobile phones. One, was a woman who was driving far too close behind me and had a child in the back, two were in large lorries, one of which was taking a really tight turning at the same time.


    To provide a snapshot of the scale of road accidents in London, and the pressure this puts on emergency services, our live map is showing road accidents across the city today. So far 21 accidents have been plotted on the map.

    Crash24 map
    London Ambulance Service,

    tweets: Call just come in from @metpoliceuk - collision involving 2 cars in E7. One patient reported #crash24

    Jacqui, in Spalding, Lincolnshire,

    emails: A member of my family is a paramedic, she has answered calls to the following; 1. A lady who said she wanted a drink of water. 2. A man who asked where the nearest dentists was. 3. A lady who wanted to have new batteries in her TV remote. 4. A man who wanted the paramedic to give him a lift home. Since the decline in out-of-hours GPs, the A&E departments and ambulance services are used on a daily basis for nothing to do with an emergancy. These people should be charged with the cost of an emergancy call-out. Paramedics do a fantastic job and are the backbone of the NHS.


    tweets: RTA in Wimbledon. Female driver, unknown injuries #crash24


    BBC London's Chirag Trivedi is replacing Adrian Brown in the control room at London Ambulance Service Central for a few hours. He tells us of two newly-reported incidents. The air ambulance has been sent to an accident involving a scooter and van in Dagenham. Response vehicles have been dispatched as well. And in Romford, there is a head-on collision between two cars. A head injury is reported there.

    London Ambulance Service,

    tweets Our Deputy Director of Ops says it's important that we get an exact location when you call 999 so we can there more quickly #crash24

    1350: Chirag Trivedi BBC News, in London Ambulance Service Central control room

    The call to the two-car incident in Romford has been cancelled. But now the control room has a report of a car in collision with a bollard in Wimbledon.


    tweets: #Crash24 I always wondered, do Paramedics just bomb it over Speed-Bumps or do they have a technique for avoiding them?

    @chrisscribbles, Birmingham,

    tweets: Re Andy 13:28 Be interesting if a speedy response would be justified if it was somebody you care about needing help? #crash24

    1349: Ed Davey BBC London

    On the move again. This time the incident is simply described as 'car vs bollard'. The victim, a female in Wimbledon, is said to have abdominal pain.

    NW London & Chilterns Group of Advanced Motorists,

    tweets: #crash24 a fascinating project & eye-opening. All road users need to learn, and take more care over what they do

    1354: Debabani Majumdar BBC News

    The bike has been removed from Bounds Green Road and traffic is going by.

    1401: Ian Ramsdale BBC London

    Back on the road with Pete, who says we're going to head back over to north-east London again to cover that area. "Generally evenings are busier, from end of school into the early evening," he says.

    London Ambulance,

    tweets: All staff are issued with protective equipment and this is also available to all observers (in response to questions about the BBC's Anjana Gadgil wearing a stab vest, see 1226)

    London Ambulance,

    tweets: Re speed bumps: We work with local authorities to ensure that traffic calming measures will not affect our response to patients #crash24

    1403: Chirag Trivedi BBC News, in London Ambulance Service Central control room

    The air ambulance wasn't sent to the incident in Dagenham. One woman suffered minor injuries and is being assessed in the back of the ambulance.

    London Ambulance,

    tweets: Staff have emergency driving training that teaches them to drive @ speed. They use their expertise and judgement to drive within the prevailing road conditions #crash24


    tweets: Following #crash24, as a London cyclist commuter I'm starting to think I got pretty lucky


    BBC reporter Lucy Rodgers sent this image of paramedic Shaun, who she has been with since 6am.

    A paramedic driving
    London Ambulance

    tweets: #crash24 responded to a collision between a car and bollard in Wimbledon, patient taken to hospital as a precaution


    This image, showing the view from a paramedic's rapid response car, was taken by a BBC reporter en route to an accident.

    A car rear view mirror
    London Ambulance

    Has posted a series of tweets with information on some of the training and equipment of their crews:

    • @skybluecj All staff are issued with protective equipment and this is also available to all observers #crash24
    • Staff have emergency driving training that teaches them to drive @ speed ... #crash24
    • ...they use their expertise and judgement to drive within the prevailing road conditions #crash24
    • All vehicles have GPS on board. The nearest resource will be sent. Other vehicles may be sent based on skill set of staff #crash24

    While our study of a day in the life of London Ambulance Service is only focusing on the here-and-now, the effects of car crashes - particularly where a fatality is involved - are felt for many years by all those involved. On Sunday, Radio 4 broadcast a 15-minute feature called Coming Out which looked at the issue from the perspective of a woman who ran down and killed an elderly pedestrian when she was 17. The sensitive programme features a psychologist called Sara Rassool who has studied Kelly's case and specialises in how perpetrators handle the process following a serious road accident. You can listen to the show on the iPlayer here.

    Craig West in Chudleigh Knighton, Devon

    emails: Reading this, you can see the amount of work these people pull off on any give day. You can also see how quickly they are able to respond to call outs. My thoughts are with those of us who don't live in London and don't have the access to such a quick response times. Maybe other counties should look on to here to see how it's done.

    London Ambulance

    tweets: A pic from an collision into a wall earlier today #crash24

    a BBC Cameraman films awall damaged in an accident
    1455: Ian Ramsdale, BBC London

    Two car collision. One male injured. He's out the car, standing, looks just a little shook up. Paramedic Pete is attending to him, assessing his neck movements and vision.

    Sara in Bristol

    emails: Andy @1328 - I don't think anyone said anything about driving at 90mph; they've covered 90 miles in distance since the start of the shift.


    The BBC's Ed Davey is in Wimbledon where a car that hit bollards is being removed. Describing the scene, he says: "A bang, a crash and the Vauxhall is earthbound once more. It has seen better days though. Residents have watched the spectacle with rapt amazement. The driver of the crippled Vauxhall, who was in her 40s, was very quiet and shaken up. She's been taken to hospital for a check up. The car was left with a blown tyre and severely damaged frontal suspension. It's now been removed. Just 25 minutes after the crash and the busy junction on Wimbledon Hill Road is moving again. It's like it never happened."


    BBC reporter Adrian Brown in the ambulance control room gives us a quick round-up: There's another lull. Post lunch, things have calmed down. Since midday, we have had six call outs. Two involving cyclists coming into contact with cars in Bethnal Green and Knightsbridge, two where motorbikes have crashed, one on the North Circular, the other in Dagenham, and a car that landed on top of a bollard and a three-car smash in east London.


    BBC News Anjana Gadgil says: No jobs for 4 hours. But at least that means the roads round croydon are safe #crash24


    BBC reporters Mario Cacciottolo, Andy Dangerfield and Tom Housden are starting the afternoon shift now. Here's a snap of them putting on their kit with the ambulance crews. They'll be working through the rush hour.

    Three men
    1518: Ed Davey, BBC London

    We head back to base in Waterloo after eight hours and eight jobs. The car has travelled 70 miles today, mostly around traffic-heavy inner london boroughs.

    Ian Sewell in Taplow

    emails on his own experience of being in an accident: It's not just serious accidents that have long term effects. I was knocked off my bike 25 years ago at uni and I was discharged from hospital with "cuts & bruises". Now I have persistent knee, hip and lower back problems as a direct result of this accident.


    If you do find yourself at the scene of a road traffic accident, it's important to know how to respond so the BBC Health team have put together the following advice about how you should react


    Mario and Pete Our paramedic car is weaving through the busy north London traffic. Currently in Wood Green, where Pete says he often attends to victims of knife crime. Still awaiting our first call today.

    Marc Ashdown, BBC London News

    tweets: Hats off to London's drivers. Not a sniff of an accident for an hour. But here comes the school run. #crash24

    1532: Debabani Majumdar, BBC London

    We are on Edgware road, heading back to the base in Waterloo. In the eight hours with paramedic James, we travelled more than 93 miles and sped through London at speeds of up to 100mph, covering mostly north and north-west London. James says: "For us it's been very quiet, which is good for the public".

    Elizabeth Stevens in London

    emails to ask: Reading the day's events, why have ambulances been sent out to many of these calls when half haven't been conveyed to hospital? Or is it the 'norm' now, or people's fears of being sued, that ambulances get sent out so it's documented so people can make a claim?

    1534: Andy Dangerfield, BBC News

    tweets: Off to West London with paramedic Spence who used to be a solicitor before retraining as a paramedic He's 'never looked back' #crash24


    Andy and Spence: Lights and sirens on, heading through heavy traffic. Reports of child and vehicle in incident.


    Here's a photo of paramedic Sam and our BBC reporter Tom Housden as they start their afternoon shift.

    BBC reporter Tom Housden starting his shift with paramedic Sam

    Andy and Spence: Arrived at scene at a primary school in Ealing. Another ambulance at scene. It appears a four-year-old girl was involved in an incident involving a van.


    Mario and Pete Our car gets its first call - someone has fallen from their bike in the Finsbury Park area. Luckily we are just around the corner, so speeding there now.


    Cyclists can feel very vulnerable on the streets of London but both drivers and riders can act to make them safer. Transport for London offers advice and training to help reduce the risks.


    Andy and Spence near a primary school in Ealing: The girl is taken into the ambulance. She appears to have bitten her lip and will be taken to hospital as a precaution.


    Mario and Pete A man has fallen from his bike in Finsbury Park. He rode into a hole covered in leaves and has hurt his elbow. Pete is giving him gas and air: "It's the same stuff that they give ladies when they're having babies," he says reassuringly.


    Here's a photo of Andy(left) and Spence before they set off.

    BBC reporter Andy Dangerfield and paramedic Spence
    1553: Debabani Majumdar, BBC London

    Heading out to another assignment just as we are on Park Lane heading for LAS base. Reports of a female, 30, fallen off her bicycle in Battersea Park, south-west London. There was a dog in front of the bike. Initial reports of wrist injury.

    1555: Anjana Gadgil, BBC London

    Another crew got to call from Morden first. Man fell off bus, in lots of pain, and being given gas and air. He's being taken to hospital.

    Waraila in Lancaster

    emails: LAS and other ambulance services are underrated by the general public, they go to so many horrific scenes and we just take those people. who save lives on a regular basis, for granted. This is an intresting snapshot into one aspect of the service, dealing with traffic accidents. Would be intresting to see a more generalised one to show how people also misuse the ambulance service as well.


    Andy and Spence Assigned to second incident in Hayes. Reported to be a man involved in incident with vehicle.


    Mario and Pete Turns out the injured cyclist was knocked off his bike by a bus a few months ago. An ambulance has arrived and is now taking him to hospital. "Looks like he's got an open fracture or dislocation in his elbow," says Pete.

    1609: Debabani Majumdar, BBC London

    Female patient in Battersea located - she waved the car down as we were looking for her and fears her hand may be broken. She looks agitated and in pain. Paramedic is offering her some pain relief but she has refused it and says she wants to wait for an ambulance and be taken to hospital.


    Andy and Spence Lights on racing at 60mph along Uxbridge Road. My foot must have hit my "invisible brake" at least a dozen times.


    Andy and Spence Arrived at crash scene in Hayes. An ambulance and police are at the scene. A man is lying in centre of road.

    Dominic Williams in W12, London

    emails with a question about sirens: Can someone please explain why the sirens on London's emergency vehicles are almost constantly on full blast, even when there is no obvious need to further warn pedestrians/cyclists/motorists of their presence? I have spent a lot of time in many large cities in Europe and there is nothing like the amount of over use of sirens by their emergency vehicles. There seems to be no difference in how fast they are able to travel through their respective busy streets and the drivers seem to be able to negotiate past all the other road users without any loss of safety.

    1614: Ed Davey, BBC London

    It's amazing the sheer distance the crews cover on a normal shift. We've been all over London and back and forth over the Thames several times. Without the sirens and the ability to wind through the traffic skilfully it would have taken days. The service hasn't seemed stretched today. But on a busy afternoon the calls can really mount up - and before you know it the crews are really up against it. The sheer amount of organisation required to cover a vast sprawling city like London - and get to the vast majority of patients in under eight minutes - is breathtaking.


    Andy and Spence Injured man has a leg inquiry. He has a fracture according to paramedic Spence. It appears the man was a pedestrian hit by a car. Four paramedics are attending to him and the road is blocked off.

    1623: Adrian Brown, BBC News, in London Ambulance Service Central control room

    Pedestrian involved in a collision with a car in Enfield. Fast response car and an ambulance on their way. Paramedic Lerroy and BBC London's Chirag heading there now.

    1625: Mario Cacciottolo BBC News

    Just one person to attend to so far for the V146 crew. Pete clearly has a broad knowledge of London's roads, barely glancing at his sat nav as he makes his way around the car-choked streets. His manner with the injured cyclist was efficient but relaxed, making sure the man kept calm while he was being treated. As the light and the temperature falls fast, we await our next call.


    Andy and Spence Man with fractured leg conscious. The 22-year-old has been put onto a stretcher and put in an ambulance. He's being taken to a west London hospital.

    1629: Debabani Majumdar, BBC London

    We waited in the Battersea Park with the cyclist and two park police officers for 25 minutes for the ambulance to arrive. Paramedic James said the case was the lowest priority case - listed as C4 - therefore the wait. It looks like a sprained wrist or possibly a fracture on the left wrist. The patient was agitated.

    1631: Chris in Winchester

    emails regarding Elizabeth Stevens' comment between 1532 and 1534: The fact that half the people who needed assistance from the ambulance service did not go to hospital shows that our ambulance service is great at what it does in treating people at the roadside. Some people may need treatment from paramedics but not need hospital treatment. Are you saying you would like to see all those who have been injured, no matter how small, be taken to hospital and take up more resources and money?


    When you're being followed by an emergency vehicle, it's all too easy to panic. According to The Institute of Advanced Motoring, a charity specialising in safe driving, there are five key things to bear in mind.


    Mario and Pete Paramedic Pete attending to the injured cyclist in Finsbury Park.

    Paramedic Pete attending to the injured cyclist in Finsbury Park.
    1638: Chirag Trivedi, BBC London

    A 12-year-old boy in his school uniform has been hit crossing the road by a car. He has a head and leg injury. Police on their way.


    Andy and Spence We've left the scene. Spence says two incidents by this time on a late shift is fairly typical. We're now heading towards busy roads around Heathrow for rush hour. New software in the control room predicts where crashes are more likely to occur.


    The start of the rush hour has seen an increase in call outs. Our live map showing road accidents across the city now has 31 incidents marked on it.

    live map

    Congestion can make accidents more likely. To check congestion before you travel, visit our live travel news page.


    Dom and Steve We've clocked up the miles today - 135 miles in nine hours. In that time we've attended six road accidents, only two of which resulted in people going to hospital - a cyclist and a pedestrian who both collided with cars. That's got to be a good result for those out on the roads today. But even though the injuries weren't life-threatening or very serious, there was always an ambulance or paramedic car on the scene within minutes of a call. These fast response cars circling their patches and reaching accidents first are not only a lifeline but also help decide what other resources should be deployed - or not deployed in some cases. As a driver and road user, seeing things from the paramedics side today did put a few things into perspective. The blue lights and sirens you see in your rear mirror really do mean get out of the way. And although you might eventually make the effort to move and let the ambulance pass - think which way you're going. There were a few times today when drivers dutifully pulled over when they noticed the lights, but into the path of the response car. And passersby calling in accidents, be as precise as you can with the location - it can save time and who knows, maybe a life.

    1651: Tim Collins in Sittingbourne

    emails: This is a fascinating exercise and quite addictive reading! Please consider doing a similar thing across all incidents, not just RTIs, as mentioned by an earlier poster.


    Mario and Pete Our lights are flickering off road signs as we dash towards a traffic accident in Edmonton.

    1656: Chirag Trivedi, BBC London

    Injured boy's upset father has turned up. He's reassured that his son's injuries are not life-threatening and accompanies his son to hospital in the back of the ambulance.

    1657: Adrian Brown, BBC News, in London Ambulance Service Central control room

    999 latest: Control is buzzing again. It's the evening rush hour. Two calls in quick succession. Both motorbikes involved in collisions with cars. One in N18, Edmonton, the other in Croydon. Both major feeder roads into London. Ambulances on their way.


    Tom and Sam Twilight falling over Newham and we've had a very quiet start to the evening shift with no calls so far. There's been a steady flow of regular ambulances into Newham hospital, but no-one in our immediate area so far has required our services.

    London Ambulance

    tweets: Staff are taking the boy involved in an RTC in Enfield straight to the major trauma centre in Tower Hamlets with head injury #crash24


    Mario and Pete An ambulance, two paramedic cars and a police car attend the accident in Edmonton, but turns out the injuries are thankfully minor. A car collided with a motorcyclist and the rider came off worse.


    The BBC's Mario Cacciottolo takes a photo of an ambulance attending an accident in Edmonton.

    Picture of traffic accident in Edmonton
    1707: Chris in Eastbourne

    emails regarding Dominic Williams' comment between 1611 and 1614: I am a police officer who drives traffic vehicles. When I attend an emergency call I use the sirens the majority of the time. It's purely for safety. I want to warn as many people as possible that I am coming - motorists, pedestrians, cyclists, motorcyclists etc. This includes the ones you can't see - on foot or in a car just round the corner or much further ahead. I want to get to the scene as safely and promptly as possible, but safety is paramount.

    1710: London Ambulance

    tweets: It's starting to rain. According to the highwaycode stopping distances are @ least double those required for stopping on dry roads #crash24

    1711: katepumfrey

    tweets: Saw the #crash24 team in #Hayes doing a good job looking after a man hit by a car..

    1717: Debabani Majumdar BBC News

    It was an exciting as well as a humbling experience. The sound of the sirens and the rush of adrenalin as we sped through the capital is indescribable. It was humbling because we were racing against time to reach somebody who has been in an accident and the paramedic doesn't know the exact condition of the patient until he reaches him or her. In addition to their medical training, they need presence of mind to calm agitated victims, at times explaining why their case is not treated as a priority, and try to forge a road through the solid wall of traffic during the rush hour. Paramedic James said: "Seeing what ambulance crews did inspired me to become a paramedic. The beauty of the job is you never know what's going to happen." Spending the day as "Victor 152" was an eye-opener about what a paramedic faces every single day, and we had a 'light day' attending three incidents - two cycle collisions and one bike crash. Thankfully none of them was seriously injured.

    Joe Worth in Cambourne

    emails: This has been a fascinating day of reading. You have got a great balance of roving reporters, tweets, pictures and comments. Please repeat this Live day again! And thank the ambulance staff and paramedics for the brilliant work they do.

    1720: Adrian Brown in the London Ambulance Centre control room

    999 latest: Just heard sirens over the PA in the control room. That's Lucy and Shaun heading to a two-car collision. Two children injured.


    Mario and Pete Stopping off briefly for a quick kebab, to fortify us for the night ahead. Kebab staff welcome us warmly, fuss over our order and offer tea while we wait. Major respect for the paramedics.

    1733: Lucy Rodgers BBC News

    Paramedic Shaun is negotiating dozens of nighttime hazards at high speed. It's a special skill.


    Mario and Pete We leave the kebab shop with free drinks and hearty goodbyes. Pete had his radio with him so any calls would have been picked up. Just as we get back to the car, one comes in. We're speeding off to an accident on the A1 between two cars.

    1738: Anjana Gadgil, BBC News

    Another paramedic treating biker when we arrived at the Croydon scene. Put left leg in splint, given oxygen and being taken to hospital. Lucky he wasn't hit by a car when he came off, says paramedic Martin.


    Lucy and Shaun In Tooting, south west London, at a two-car crash. Occupants, including children, are shaken up but all well. Mother bumped her head, but appears to be fine. She probably won't be taken to hospital.


    Mario and Pete Arrived at the site of the collision, at the side of the A1. Two cars came together, drivers now exchanging details but one of them had his baby daughter strapped into the back seat. Pete's checking her now.

    1747: Chirag Trivedi, BBC London

    Heading into central London now. Apparently there is a protest in Parliament Square that the London Ambulance Service is keeping an eye on.

    1748: Anjana Gadgil, BBC News

    Another job. An 80-year-old has fallen off bus in Beckenham. Possible head injuries. On way now.

    1749: Adrian Brown in the London Ambulance Centre control room

    999 another call - lorry and a car in N11, outside a tube station. No details on the condition of any occupants. "Two patients" we're told here in the control room, and paramedic Leroy and BBC reporter Chirag are on their way.

    1755: Chirag Trivedi, BBC London

    Thankfully no-one hurt in the Bounds Green incident. Low impact accident with the car losing its rear bumper.

    1758: Adrian Brown BBC News

    In the last half hour the control room has taken calls for several incidents. Thankfully most have turned out to be minor incidents with minor injuries. Radio just crackled into life. Another call. Again on the A13, car v bicycle. Paramedic Sam and BBC reporter Tom are on their way.


    Here's a picture taken by BBC London's Debabani Majumdar earlier, after a 30-year-old man on a courier bike fell off his vehicle on Bounds Green Road in north London at about 1.20pm. He was taken to hospital with a wrist injury and bruising to the chest.

    Man being loaded on to ambulance

    Andy and Spence are going out from Vauxhall to an incident in E3.


    The BBC's Chirag Trivedi took this photo at the scene of an accident at Bounds Green. Thankfully no-one was hurt, but the car lost its rear bumper.

    Bounds Greed incident

    Tom and Sam: We find a shaken young man sitting on the kerb nursing his ankle and knee. An ambulance quickly arrives and he's assessed in the back. He doesn't think he needs to go to hospital; the bike has come off worst with a snapped stem.


    Andy and Spence in Whitechapel, east London, say they have been through six red lights at 70mph. Heart-racing stuff.


    Andy and SpenceArrived at scene in E3, where police and ambulance are also attending. A 30-year-old motorcylist has very minor injuries after coming off his bike. There were no other vehicles involved. He's currently being interviewed by police.

    1824: Kerry in Walthamstow

    I have a lot of respect for the ambulance service. My dad is a paramedic and I don't think people have their priorities right due to the fact that they really are lifesavers and people don't have the same respect for them as they do for other services.

    1833: Adrian Brown in the London Ambulance Centre control room

    Control room buzzing. It's change-over time when the day shift makes way for the late shift. BBC London news reporter Marc Ashdown is doing a live into the evening BBC London news programme now.


    He says throughout the day the control centre receives about 4,000 calls and about 80 of them involve road traffic incidents.


    He'll be speaking to Jason Killens, Deputy Director of Operations at the London Ambulance Service, shortly.


    Mr Killens says that as the number of cyclists increases on London roads, they are seeing an increasing number of accidents involving them. His advice to drivers is to look out for cyclists and motorcyclists.

    He also says that if you do come across an accident, call the service, ideally from a landline. And as winter approaches with darker conditions, be sensible. People need to take care, look out for the vulnerable, pedestrians and cyclists, he says.


    Andy and Spence On our last job, we got from Vauxhall to Whitechapel in 12 minutes. Never seen so many London landmarks in such a short space of time.

    1843: Ian Ramsdale, BBC News

    Sitting in a paramedic's car waiting for a call to tell you someone has crashed their car is a rather peculiar feeling. It's something paramedics themselves are rather used to. On the one occasion where we got to our planned waiting location before "a call" came through, we were on the scene within two minutes as it was just north of the where we lay in wait. Lucky, definitely - but it shows how well positioned response vehicles can be. Thankfully none of the incidents I attended involved serious injury, but they were definitely some serious accidents; man cut out of car; three-car shunt on the North Circular road; and discovering an abandoned car in the middle lane of the A13 Canning Town flyover... they'd run out of petrol. Paramedics have to deal with a variety of situations, but having the privilege of seeing how they do it, first hand, really opens your eyes as to how they cope. I hope we've conveyed that to you throughout the day.


    Tom and Sam After a brief pitstop back at base we're off to SE10 now - reports of a collision between a car and a motorbike.

    1855: Anonymous in London

    emails in response to Chris in Winchester's comment at 1631: You talk about money and resources, well you would be shocked at some of the calls London Ambulance Service attend. How would you feel if a member of your family had to wait 20, 30, 45 mins for an ambulance because a patient that didn't want to wait in the waiting area of an A&E department went outside and called for an ambulance because he thought he would get seen quicker if he was taken in by ambulance, or because someone had broken their nail - now that's a waste of resources and money. Maybe sending a rapid response car to assess the patient and letting the paramedic decide if that patient needs an ambulance would be a better response, leaving ambulances ready for life-threatening cases?


    Tom and SamBlue lights help make light work of the rush hour traffic at Elephant and Castle. Well, light-ish.

    1900: Tom Housden BBC News

    Paramedic Sam says tailgaters - motorists trying to follow the path cleared by the fast response vehicle's sirens - can be a problem when it's busy.

    1906: Mario Cacciottolo BBC News

    Several hours in and it's clear that a shift with a London Ambulance paramedic involves high levels of concentration at a moment's notice, interspersed with periods of quiet. Snapping into action quickly and always being on top of your game when required are vital parts of the role. Pete has seriously good driving skills too, carving through London's traffic like a hot knife through butter.


    And here's a photo of the BBC's Mario (left) and Pete during their shift together.

    Mario (left) and Pete the paramedic

    Tom and Sam In Woolwich, south-east London, a pizza delivery man has fallen off his moped after hitting a greasy patch at a junction. He seems okay, but the ambulance crew at the scene will take him hospital for a check-up.


    Tom: Sam says it's a tradition that calls to pizza delivery mishaps result in a free pizza donation. We missed out this time though.


    If you have any questions about road accidents, take a look at our guide, which talks about twin peaks, trunks roads and rush hours.

    1931: Andy Dangerfield BBC News

    Paramedic Spence is certainly very calm and experienced at his job. The chocolate snacks have also been a great help in seeing us through the 10-hour shift. We've regularly been hitting 90 miles per hour on our way to incidents - certainly a novelty for me. Before today I don't think I've driven more than 10 miles per hour in central London.

    1938: Adrian Brown in the London Ambulance Centre control room

    Latest 999 from control room - three calls have come into the control room in the last half an hour. Another motorbike and car collision in SE10. Very minor injuries apparently, but enough to go to hospital. An elderly lady grazed by a car in Cheam High Street, and another crash between a motorbike and a car. That one in SW1. And as I write, another emergency call just in, involving a bus and a woman in her 60s.


    Tom and Sam Another call, it's Brixton this time, reports of a pedestrian hit by a bus.

    1943: Adrian Brown in the London Ambulance Centre control room

    Another accident involving a motorbike - this particular bike has collided with a car in Leyton.

    1951: Anjana Gadgil BBC London

    A quiet start to my day with the LAS, but a very busy last few hours. We travelled to Croydon from HQ at Waterloo, and I used the opportunity to quiz paramedic Martin on the important aspects of his job: how does he manage to stay alert on a 12-hour shift; what does he do when he needs the toilet. But when we got our first call-out after 4 hours of waiting, I realised how professional he and his colleagues are.

    He went from relaxed and chatty to fully focused; sirens on, navigating a safe route through after-school traffic at break-neck speed. We went to three jobs in three hours, in Morden, Croydon and Beckenham. Two people who'd fallen off buses, which I'm told is a common occurrence, and one man who'd come off his motorbike while swerving to avoid a car. All three went to hospital, but no-one was seriously hurt, and I realised that reassuring the patients was just as important as seeing to their injuries. But, as we raced around the city to get to the next job, I also realised I get far too travel-sick to be a paramedic's regular passenger!


    Tom and Sam Confused situation here in Brixton. An elderly woman has been found in the busy road, but it's not clear what happened or whether she was actually hit. She's being assessed by other responders. Traffic is backed up a long way down the road, with police trying to clear the scene.

    1955: Chirag Trivedi, BBC London

    I had a unique perspective on #crash24. I spent the first few hours in the control room; collating the information coming through, working with those deciding who goes where and getting a bird's eye view of the incidents from the "jam cams".

    I was then thrust at short notice in the adrenalin-filled world of speed, blue lights and sirens. Speeding down Park Lane at rush hour watching the traffic part was an amazing experience.

    But before that I had to watch an anxious father wait as the paramedics treated his 12-year-old son who had been knocked down by a car. The boy will be okay. But the paramedics, including the one I was with, Leroy, handled the boy and the father in a very stressful situation - in the cold, in the dark and in the rain - with care and compassion and with a smile on their faces. As they do every day. That was just as an amazing experience.

    2005: Adrian Brown in the London Ambulance Service control room

    A few minutes of calm are broken by two incidents arriving at once. One is a van going into a ditch in Barnet, and the other involves three cars colliding in Ruislip.


    Tom and Sam The woman in Brixton seems to be alright, but is being taken to hospital for checks. It seems that she somehow hit the side of the bus, but how it happened remains unclear. So, we're back on patrol, with temperatures dropping fast in south London.

    2007: Adrian Brown in the London Ambulance Service control room

    Reports are coming in of a "multiple vehicle" accident in Hillingdon, west London. More on that as we get it - the ambulance service was alerted by the fire brigade, who are en route.

    2013: Lucy Rodgers BBC News

    Paramedic Shaun, who I spent the day with, does some shifts for the Helicopter Emergency Medical Service in London - the air ambulance. The helicopter and its associated equipped cars act as a roadside emergency room when timing is critical. At its HQ, beneath the helipad at Royal London Hospital, the team tells me how they've dealt with 1,922 patients so far this year.

    Their top call-outs are road crashes, falls and penetrating trauma (when an object enters the body). There have been 662 road crashes - of those 299 were pedestrians, 115 motorcyclists, 96 drivers, 81 vehicle passengers and 65 pedal cyclists - along with others.


    Graham Chalk, the lead paramedic with the air ambulance, says the most difficult thing for the team is making sure they respond to the right calls - only those that are most critical.

    "We only have one resource," he says, "and we have to marry the need with that resource." Paramedics and doctors spend a number of months with the air ambulance on a rotating basis. This is seen as crucial for their trauma training.

    "For a paramedic on the road, they'll see one major trauma case per year on average," he says. "With us a paramedic will get 100 years of trauma training. We're then getting that training back out to the ambulance service and medicine is all about experience," Mr Chalk says.


    Tom and Sam: No sooner than we hit the road again, another call - it's straight back up the road to SE1 with reports of a taxi in collision with a bike.

    2019: Adrian Brown in the London Ambulance Service control room

    The cyclist in Lambeth is apparently complaining of rib pain and a wrist injury. The accident in Hillingdon has been confirmed as being the same one as reported in Ruislip. And the police have just informed the ambulance service of an incident in the City, involving a traffic accident. Two men are injured, one of which is a 36-year-old complaining of leg and arm injuries.


    The BBC's Lucy Rodgers took this photo while out with a paramedic earlier.

    View of London from the ambulance
    David, in Glasgow,

    emails: Amazed at the comments about speed and excessive siren use. I'm sure if ever these short-sighted commentators ever need an ambulance, they will insist during the 999 call that the ambulance be driven slowly and keep the sirens off so as not to disturb the neighbours. These crews are highly trained in the appropriate use of speed, and in the right circumstances none of the speeds mentioned in the report are necessarily dangerous. Likewise I would trust the emergency driver's judgement as to when to use his siren, more than that of a disgruntled bystander.


    Tom and Sam: A taxi and a cyclist have come into contact on a roundabout and unsurprisingly, the cyclist has come off worst. He's hurt his wrist and it looks like he'll need some hospital attention.

    2031: London Ambulance Service

    tweets: We've been to over 50 road traffic collisions today - remember to take extra care if you're out and about on the roads tonight #crash24


    Mario and Pete Heading into the City now. Pete informs me his colleagues are ribbing him after I compared his rush hour driving to a hot knife slicing through butter.

    2033: London Ambulance Service

    tweets: We've got a single responder and an ambulance on scene at the van in a ditch in Barnet #crash24

    2044: London Ambulance Service

    tweets: A woman in her 60s has been taken to St Helier Hospital after an RTC on High St Cheam earlier this evening. It was a motorcyle v cycle in the City. We've got staff on scene assesing two patients with minor injuries #crash24

    @welshdragon1987, in Abergele,

    tweets: Watched #crash24 coverage today - such an insight into the life of a paramedic. Can the BBC do one in a rural/town mix?


    Andy and Spence Heading from St Paul's out to that incident in Ruislip, north-west London.

    @MichaelSnasdell, London,

    tweets: Astounded at the number of RTC's in one day in London during #crash24 . Hope London is grateful for having such a service as @Ldn_Ambulance


    Mario and PeteBoth men injured in the City are "walking wounded". An ambulance crew is taking care of them.

    2048: Anon, in Dursley,

    emails: Is there only one Air Ambulance helicopter to cover the whole of London and is that enough?


    Mario and Pete We're now in the City, with an illuminated St Paul's dome looming above the buildings. Pete says he wanted to become a paramedic after a childhood incident. His friend fell off some playground monkey bars and hurt her back. Paramedics came "and were absolutely brilliant," says Pete. "I went home and told my mum that's what I wanted to do when I grew up. But I became a qualified plumber first."

    2053: Adrian Brown in the London Ambulance Service control room

    Suddenly gone very quiet. Only six calls for all types of incidents coming into the control room. "No rhyme or reason to this," says dispatcher Steve. "Last night we had screen after screen full of calls and now nothing. This is the level of calls you get at four in the morning, not on a weekend evening. Mind you, the football will be over soon and then we'll get some."


    Andy and Spence Siren echoing in tunnel on way to incident in Ruislip. Spence says: "There's certainly no excuse for people not seeing or hearing you coming".

    2057: John in Concord, NC, USA

    This has been brilliant coverage - as a motorsport flag marshal and first responder, I really appreciate the need for speed and accurate triage of cases. Too bad not all 'civilian' drivers are aware of the proper reaction to 'blues and twos' behind them or how to make an emergency call properly. Hats off to all first responders everywhere!


    Andy and Spence We have been told an ambulance is already at the crash scene dealing with a casualty in Ruislip. We are still heading there at high speed as there is believed to be someone else hurt.


    Tom and Sam Back in Whitechapel it's gone quiet again. We're contemplating a cup of tea - a guarantee, says Sam, that we'll immediately get another call.


    Andy and Spence At crash scene on A40. Two cars involved. One casualty taken to hospital. Two others with minor injuries. Police have arrived. One lane cordoned off.

    2111: London Ambulance Service

    tweets: There's a 45-year-old man in Hoxton with ankle injury following an RTC - another call from the police #crash24

    2123: Adrian Brown at the London Ambulance Service control room

    Just had a call into the control room. "Multiple vehicle incident" on the M4. five or six vehicles. Several ambulances heading out there. Hems, the emergency helicopter service for London, has been alerted.


    Andy and Spence: We've been sent to a crash on the M4. Sounds serious.


    Mario and Pete: We're currently in Hoxton, trying to locate the accident. No sign of it at the moment.

    2125: London Ambulance Service

    tweets: There's only one air ambulance in London. Check them out @TheHelipad #crash24

    2130: Adrian Brown

    Earlier in the day, there was a call reporting a collision between a car and a deer in Romford. Apparently the car driver refused assistance. Ambulance was stood down. Hope the deer was ok.


    Andy and Spence Travelling at high speed to reported serious crash on M4. Spence says you rarely get a call like this.

    2134: Adrian Brown in the London Ambulance Service control room

    Quick update on the M4 situation. Thankfully, not as serious as first thought. Five patients, four vehicles. The London Fire Service are at the scene.

    2134: James, in Surrey,

    emails: Regarding the comment of Anon in Dursley at 2048 - Yes, but sometimes controllers will involve multiple air ambulances from across the region for incidents involving many killed and seriously injured people. A good starting point to watch this in action is the BBC documentary series "Helicopter Heroes". Sometimes, in a large city, a motorcycle can be used to get the quickest possible first response to a casualty. Once they are stabilised, they can be moved to a hospital by a road ambulance and then, if necessary, transferred by helicopter. You can imagine the problems any pilot faces landing in an area crowded by people, buildings and general infrastructure.


    Mario and Pete Found the incident - motorcyclist has come off his bike when trying to avoid a car and has hurt his back. Pete's checking him over. Policeman at the scene tells me he's got the "utmost respect for paramedics".


    Our live map showing road accidents across the city now has about 60 incidents marked on it.

    Collisions across the capital
    2140: Adrian Brown in the London Ambulance Service control room

    "So often, the incidents that sound the worse turn out to be less serious," says dispatcher Steve as the M4 incident is being dealt with. "However, you have to err on the side of caution. Especially as the ones that come in and are a bit vague can turn out to be really nasty."

    2141: London Ambulance Service

    tweets: One patient taken to hospital after earlier van v ditch on Camlet Way, Barnet #crash24


    The BBC's Tom Housden took this photo at the scene of the taxi-bike collision in Millbank earlier. The diagnosis was a likely fractured wrist.

    scene of the taxi-bike collision in Millbank

    Andy and Spence This is a very serious pile up. Multiple cars involved, two fire engines at scene. About six police cars and at least two ambulances. Entire M4 westbound is blocked off. Five people reportedly with minor injuries at the moment. A lot of people in shock.


    Mario and Pete Our motorcyclist in Hoxton is a pizza delivery driver. His food has gone missing from his box, apparently. Someone's dining for free in Hoxton tonight.

    2146: Adrian Brown in the London Ambulance Service control room

    Calls coming in thick and fast again. One to a pedestrian outside new Scotland Yard who has come into contact with a car. Also a woman on Pentonville Road, Camden, who has had her foot run over by a bus. Ouch. Apparently she says she doesn't need an ambulance. And as I write, another to the British Museum. Again conflict between a car and a pedestrian.

    @_bradders, in Manchester,

    tweets: Reading these tweets about ambulances driving too fast. Trust me I work taking calls for north west ambulance, people want them fast! I'm told often enough to get the ambulance there sooner. It's just not safe for ambulances to go any faster than they already travel to people. Emergency means emergency #crash24

    2148: London Ambulance Service

    tweets: On the way to a car v cyclist in Woolwich. Called about a collision between a car and pedestrian in Bloomsbury #crash24

    2153: Adrian Brown in the London Ambulance Service control room

    Another car and pedestrian. Umpteenth car and cyclist collision today. This one in Woolwich... and another in Lewisham. Ambulance crews on their way.


    Mario and Pete There's a delay while we await an ambulance for the Hoxton biker. There are none available, so the 23-year-old has called his parents to come and pick him up.


    Tom and Sam We're near Victoria and what looks like the most serious call we've been to all night. A woman is lying immobile in the road. She's conscious and paramedics are giving her gas and air.

    2201: BBC London's Jane Bradley

    tweets: I am loving the brilliant tweeting from @ldn_ambulance today. Really personable and highlights the good work they do. #crash24

    2202: London Ambulance,

    tweets: Going to Elephant & Castle to yet another car v ped, we'll have to count these up at the end of the night #crash24


    Mario and Pete Hoxton biker has now phoned a friend and he is taking him to hospital for a check-up. The driver of the taxi he was nearly in a collision with is still here though. "Why's he still here?" Pete asks. "Because my colleague has his driving licence," replies the policeman.

    2207: London Ambulance Service

    tweets: We've been to 14 collisions involving cyclists today. Please take care on the road, and wear your helmet #crash24


    Andy and Spence At the accident on the M4, Shiv Gulati, 23, says: "We pulled up behind the accident. We saw three bodies at the side of the road. One person was unconscious inside a car. I phoned the ambulance: I'm just glad everyone's ok."

    2208: London Ambulance Service

    tweets: We've got an ambulance and motorcycle responder on scene at the bus v foot incident in Islington #crash24

    @2310luke, in Norwich,

    tweets: Been following #crash24 all day - please do this again!! It has been gripping!

    2212: Andy Dangerfield BBC News

    Ajay Gulati, 14, from Slough, was a passenger in a car that arrived just after the crash on the M4. He says: "I'm shocked to see what happened. To see how the ambulances and police reacted is reassuring."

    2213: @watty,

    tweets: been following @bbcnews #crash24 coverage all day, all I can say is a heartfelt thanks to the paramedics @Ldn_Ambulance @bbc_haveyoursay


    Tom and Sam: The woman injured outside New Scotland Yard has a broken arm and and some grazes, and she'll soon be going to hospital. Ambulance staff worked as a team to delicately move her into the ambulance. Now we need to delicately move around this police road block.


    The BBC's Mario Cacciottolo took this photo of paramedic Pete in Hoxton with the injured rider. He's taking note of his blood pressure.

    photo of Pete in Hoxton with the injured rider
    2222: Tom Housden BBC News

    Sam says there are no hard and fast rules on how to deal with shaken accident victims. "Some are upset, some get angry, you just have to try and take it as it comes".


    Mario and Pete Leaving Hoxton now. There's often a humming noise to be heard while we're driving, audible even over our blaring siren. But there's nothing wrong with our car. It's ex-plumber and family man Pete, who seems quite partial to Lady Gaga, among other artists. We've got a traffic accident in Islington to attend to. Pete, humming Eternal Flame by the Bangles, puts his foot down and gets us on our way.

    2223: @OliBarrett, in London,

    tweets: Delays on M4 lead me to the fantastic work of @Ldn_Ambulance . See #crash24 for a glimpse into their day:

    2225: London Ambulance Service

    tweets: M4 update: Five patients have been taken to hospital - four with minor injuries, one with a head injury #crash24


    Mario and Pete We've arrived in Islington to find a small bag burst on the pavement and a man covered in white paint. Can't wait to hear what the explanation is for this one. Man seems to be okay.

    2230: Andy Dangerfield BBC News

    The traffic police investigator in charge at the M4 accident says: "An investigation is underway. A stationary car is believed to be involved. Our priority is to get traffic moving again."

    2231: George de Naeyer, in Barnet,

    emails: Really enjoying this, great insight into how the Ambulance service works and is run so efficiently. Would be brilliant if you could do this same sort of thing for the Fire service and Police too. Great work guys and gals, and huge well done to all the paramedic and ambulance staff.


    Tom and Sam Sam normally works alone, so tonight as the front-seat passenger I am sitting in her "office". Paperwork chores over, and we're about to get moving again. Temperature is dropping rapidly and the streets are emptying, although pub closing time is looming.

    2234: Tom Housden, BBC News

    The police have set up an impromptu cordon here in Victoria. The woman seems to be in considerable pain. Ambulance staff are gently moving her onto a stretcher, but it's a tricky procedure.

    police cordon  in Victoria
    2235: @Lithlad, in Nottingham,

    tweets: #crash24 is mawkish, and cynically cheap entertainment. It's no better than Police, Camera, Action! and just as tacky.


    Mario and Pete: Man with paint was apparently crossing the road when he was in collision with a car. He has some swelling and pain in his thigh, so an ambulance is taking him to hospital. Police officers are tip-toeing around the wet paint and investigating the incident. We leave them to it.


    Andy and Spence Talking about the M4 incident, paramedic Spence says: ''The first thing I did at the scene was assess the situation to find out who was most seriously injured. They were already being seen to. So, I helped a distressed girl with asthma who was complaining of injuries to her chest. It was important to calm her down so she did not have an asthma attack. Given the potential for serious injury in a high speed collision, these people were lucky to escape with minor injuries."

    2243: Adrian Brown in the London Ambulance Service control room

    Update on the 30-year-old male knocked over in a collision with a car in a nasty incident on Kennington Park road earlier. He's been "blued" in to St Thomas hospital - meaning they've taken him there with blue lights flashing. Compound fracture to the leg and dislocated shoulder.


    Mario and Pete I ask Pete what his diet is generally like when he's out on the road. He tells me he does make an effort to eat reasonably healthily while on call. "I do have one vice when I'm out and about though," he says, wrestling open a large pack of chewy sweets.


    The BBC's Mario Cacciottolo took this photo of a man with a burst bag of white paint in Islington. He seems to have minor injuries.

    Man with burst bag of white paint in Islington

    Mario and Pete Pete says that road traffic accidents are often less serious these days because cars are much better made. "But we often get accidents where people are injured because they haven't worn a seatbelt. They tend to be younger drivers," he says. In 2010, of the 28,404 accidents dealt with by London Ambulance Service, about 25% were aged 21-30 and about 55% of the overall figure were male.


    Tom and Sam We're being sent to Feltham way out in west London. It's a fair old way from Waterloo but lights on and we're off.


    Andy and Spence Heading to into our last hour of the shift. Hoping there aren't too many post-Christmas party drunk drivers/cyclists/pedestrians on the streets tonight.


    Mario and Pete We've stopped off in a cafe in Soho so Pete can get a coffee. I decline one but the staff spot my fluorescent jacket and make me one anyway. We're sharing banter with a crew from Hems - the Helicopter Emergency Medical Service - resplendent in their orange jumpsuits.

    2303: James Attenborough

    tweets: reading #crash24 on the bbc reminds me of the stirling work paramedics did when they picked me up unconscious on the road 11 years ago.

    2310: Adrian Brown at the London Ambulance Service control room

    More details about the incident in Pentonville, involving a pedestrian and a car. A 30-year-old man was thrown onto the bonnet of the car as he crossed the road. Police are at the scene. The pedestrian was taken to hospital. Not too serioius, we are told.

    2313: Tom Housden, BBC News

    We've hit a late rush hour on the A4. Slow progress west to Feltham, where a cyclist has been involved in a collision.

    late rush hour on the A4
    2322: Mario Cacciottolo, BBC News

    Here's a picture of the Hems team - in a helicopter by day, in a car by night. They drop in a mention that they're a charity.

    Helicopter Emergency Medical Service  crew

    Mario and Pete: The day has been hugely interesting. Pete has carried out his work with great professionalism and a friendly touch. Everyone he's dealt with has been pleased to see him and he's helped a few people out today. It's bitterly cold but he just gets on with the job. The warm reaction he gets from the general public and cafe staff show the great respect in which ambulance and paramedic staff are held.


    Tom and Sam Fast run down the now quiet M4 to Feltham where a cyclist has hit his head after colliding with a car. He says he hit his head and felt dizzy. Sam's assessing him now, carefully checking for neck and back pain. It doesn't look like he'll need hospital tonight.

    Evan Dunn

    tweets: Interesting how #crash24 got hijacked into telling cyclists to wear hi-vis, lights and helmets. How about telling drivers not to hit them!


    Andy and Spence Lights on again. Dispatched from Bounds Green to reported crash in Crouch End.


    Andy and Spence: Arrive at the crash scene involving two cars in Crouch End. We were called here by the police.


    Andy and Spence We are first paramedics at the scene. Both cars have their fronts smashed up. One person has injured his arm.


    Tom and Sam: Our Feltham cyclist was on his way home - and it's looking like this will be our last job of the night. He's having a quick blood pressure check, the back of our Volvo fast response vehicle displaying Tardis-like capacity for medical gear. He doesn't want to go to hospital, but Sam is checking that he has someone who can be with him at home should any signs of concussion emerge.

    For us, it's been thankfully a night of relatively minor injuries but it's telling that the vast majority have involved bikes of one kind or another. We've covered a lot of south, east and west London tonight and now it's another long drive back to base. Goodnight from freezing Feltham.

    2343: Adrian Brown at the London Ambulance Service control room

    Control room have just received this call: man fell off a bicyle five hours ago and thinks he's broken his lower leg. Yes, a 999 call five hours after the incident.


    Andy and Spence Paramedic Spence is attending to 21-year-old driver who has a fractured arm.

    2354: Adrian Brown at the London Ambulance Service control room

    Two more calls just come in - a cyclist and pedestrian outside Barts Hosptial, N19, and a two car crash in Upper Holloway. Someone has a broken humerus bone - that's the large upper arm bone.

    And another call just in about an incident in Farringdon between a car and a cyclist, with reports of a broken windscreen. Ambulance on its way there.

    2356: Adrian Brown at the London Ambulance Service control room

    What a day. For last 24 hours we've been following the work of London's ambulance service as it responds to every road casualty on the capital's roads. The total for one day comes to 14 cyclists, 18 pedestirans, 11 motorcyclists with the rest being car occupants. A pretty average day as far as numbers are concerned. But a real eye opener into the work of the service and sheer complexity of the job they do scooping up the bruised and battered.

    Thankfully, no one has died and there have been only a handful of injuries serious enough to be "blued in" to hospital sirens blaring.

    Thank you for following us.


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