The pokies room is full at Easts Leagues Club in Bondi Junction, though not with the usual suspects.
On the gaudy, casino-style carpet a 49-year-old man lies unconscious, his eyes rolling to the back of his head, having suffered a cardiac arrest only moments earlier.
Around him four paramedics and three police officers fill the room, working hurriedly to revive him beneath the garish lights and frenzied tunes of the poker machines.
It is shortly before 3.30am on a Friday morning, more than halfway into the previous night's shift for ambulance paramedics across Sydney.
In the near-empty leagues club a police officer is vigorously pumping the chest of the patient, who reportedly collapsed onto another customer as the two sat side-by-side in the pokies den.
The survival rate of patients suffering an out-of-hospital cardiac arrest in NSW is less than 10 per cent. Time is of the essence.
Now on a stretcher, the man is quickly moved out and in to one of two waiting ambulances, as police and paramedics take turns in administering CPR.
Five hours earlier NSW Ambulance paramedics Eugene Roser and Gareth Garne are on their second night shift in a row.
"I'm really surprised that we're sitting around," Mr Roser says, never leaving more than a few minutes before checking his portable shoulder radio, a fifth limb for the remainder of his 12-hour shift.
This evening, Mr Roser is the designated driver.
As intensive care paramedics, or ICPs, both he and Mr Garne are among the most senior paramedics on the road, trained to handle complex cases and administer high-level cardiac drugs and opiates, like ketamine.
"That's a relatively new drug for us ... it really is fantastic. It's a dissociative, so it would be used on someone with a broken leg that needs straightening up," Mr Roser said.
"The best way a patient once described it to me was that they knew they had pain, but it was like they were on the other side of the room watching it."
The pair are enjoying a coffee on Newtown's King Street when a call comes through around 11.15pm.
A 70-year-old man in Leichhardt is having breathing difficulties, and reportedly changing colour.
On the car's internal call log it comes through as a category one job, which means "lights and sirens".
Travelling at 100 km/h and with little traffic along Parramatta Road, the ambulance reaches the home in no time, with Acting Superintendent Chris Anson close on its tail if support is needed.
After picking up the elderly patient and delivering him to Royal Prince Alfred Hospital, it's one-patient-down for Mr Roser and Mr Garne.
"People like that you can do something for. You can rehydrate them, get their fluids up, address the cardiac side of things," Mr Garne says.
"The big traumas, there's nothing you can really do in an ambulance. You're patchwork until you get them [to theatre]."
But, he says, it is always the "higher acuity" cases [complex emergency cases] that stick with him.
"I remember we had a guy on ice, that jumped off the 18th floor [of a building]," he says. "When we got there he was actually trying to fight the police off. But he had bilateral compound fractured femurs, his lungs decompressed and half his face had been knocked off."
It's around 1am and the patient from Leichhardt has been handed over to staff at RPA.
At this point the pair have 15 minutes to ensure the ambulance cabin has been fully sanitised and restocked, ready for the next patient.
"My record is three minutes, 32 [seconds]," Mr Roser says, adding that it's often easier to hose out the cabin in particularly messy cases.
Highs and lows
After nearly 10 years in the job, Mr Roser says the best and worst jobs involve babies.
"I've delivered four babies and that is so great ... but I went to an 11-day-old cardiac arrest not so long ago, that was horrible," he recalls.
"Mum fell asleep while breastfeeding and accidentally suffocated the baby. It was really quite surreal."
Mr Roser still remembers the mother grabbing him, saying, "I've killed my baby, haven't I?"
"How do you answer that? It's not the way things are supposed to go."
It's a little after 1.30am and the crew is arriving at a two-storey home in Bellevue Hill where an 82-year-old male has woken up with slurred speech. He is a diabetic and has a history of stroke.
Paramedics arrive at a Bellevue Hill home to treat a 82-year-old diabetic male with a history of stroke. Photo: Wolter Peeters
The call-out is typical for this time of night, and after an abnormality appears on his electrocardiology reading, the crew decides to take him to St Vincent's Hospital.
En route, Acting Superintendent Anson, who is still with the team, hears a troubling call on the radio.
"Methadone overdose in Glebe. Patient is an eight-year-old girl."
It is 2.22am.
NSW Ambulance paramedic Eugene Roser cleans a trolley. Photo: Wolter Peeters
As he heads towards the reported emergency, a clarification comes through from another ambulance that has already arrived.
"Looks like a custody issue. Police are here. This is not a job for us."
False reports and non-emergency calls are common for triple-0 operators, who answer a call for help on average every 28 seconds, with only 10 per cent concerning life-threatening conditions.
"I've been called twice to mosquito bites," Mr Garne says.
Back at Vinnies it has just passed 3.15am and the unconscious 49-year-old man from the pokies lounge is still down. His heart has not started in over half an hour. Sadly it won't start again.
Doctors call his time of death just after 5am.
The 49-year-old patient who collapsed at Bondi Junction died. Photo: Wolter Peeters
By now all is quiet at the Eveleigh ambulance station, where Mr Roser and Mr Garne have returned with fellow shift mates to wait out the two remaining hours of their shift.
Around the station, weary bodies drape themselves over couches and futons on the floor.
In these quiet periods, when the city is mostly sleeping, they are encouraged to "recline" and rest their own eyes, before Sydney wakes up and the calls start once again.