I park the ambulance so that the drivers going past have no option but to slow down, lights making that familiar blue pattern in the night.
My crewmate is the one looking after the patients today and her quick assessment and a nod to me makes me realise that it's going to get noisy.
I call for the fire service, we need them to cut the roof off the car.
It's my job to sit on the back seat and hold the head of the driver so that he doesn't move it around thereby possibly aggravating any neck injury.
I have to hold it tight as he keeps wanting to turn around and tell me to make sure that his papers are retrieved from the boot of the car. And that we don't forget to collect the GPS holder on the windscreen.
It's quiet, just the traffic driving beneath me and the cars driving slowly past my ambulance.
Then the fire engines turn up and it gets noisy.
Hydraulic machinery is pulled from the back of the appliances, firefighters chock the car so that it is a stable platform to work on and they start to break all the windows - covers placed to avoid the glass going on me or the patient.
My arms are getting tired, it can take a long time to remove the roof of the car.
The cutters start snipping at the car, first the doors come off then the rear pillars. They wrap a big bit of plastic sheeting over me and the patient, its like being in a tent.
I can imagine what is going happening on the other side of the sheet even if I can't see it. The cutters snip away at the other pillars and the roof is peeled back. From my side I'm in an opaque white cocoon with weird bangs and shakes coming from outside. Not for the first time I'm glad I'm not claustrophobic, instead I concentrate on my arms - the burning sensation of holding the patient's head is starting to turn into a painful numbness.
I wish I was on the other side of the plastic with my crewmate, she's getting the trolley out of the ambulance and is preparing the back board and head blocks.
Because of the helmet I'm wearing all the noises are muffled, I've taken my glasses off to stop the helmet pressing on them so my vision is blurred - not that there is much to see, just the back of the driver's seat and the plastic sheet.
And my arms, that now feel like they are falling off.
Then the sheet is thrown back and I can raise my head into the air again. Lovely.
It is then a simple task to get the patient out and tucked up in the ambulance, the fire service have, once more, done their job with expert professionalism and have made our job much simpler. They slide him up the back board while I try to rub some life back into my arms.
We wave goodbye to the firefighters who are sweeping the debris off the street and then speed our patient through the night to the hospital.