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SOMBA K'E/YELLOWKNIFE - Ambulances come in all shapes and sizes in the North.

Flight paramedics will tell you that, in different situations, they can take the form of a sled pulled behind a Ski-Doo, the cab of a pick-up truck or an even an all-terrain vehicle.

Flight paramedics Mike Cross, left, and Troy Harnish, right, and the rest of the Medic North team, respond to emergency calls around the NWT. The two paramedics say this is the most challenging environment to work in in their field. - Herb Mathisen/NNSL photo

However, the form they are most accustomed to is the King Air 200 aircraft that takes them across the North, keeping those with serious problems or life-threatening injuries while they are transported to specialists in Yellowknife or the south.

Paramedics are dispatched for a variety of medical calls, ranging from pregnant women about to give birth, to severe trauma, to transporting patients that require monitoring down south for treatment.

These dedicated professionals have a challenging job and the Northwest Territories' unique environment makes the job that much more complex.

"The challenge is the complete lack of consistency in communities," says Mike Cross, a flight paramedic for Medic North with 27 years experience and five in the North.

Cross told a story where he landed in Tulita and was greeted by a makeshift ambulance: a Ski-Doo pulling a sled. He had to haul $120,000 worth of medical equipment out to a hunting shack eight-kilometres out of town in cold temperatures in response to a cardiac arrest.

The long distances and lengthy flight times between communities, frigid winter weather and even wildlife like polar bears lurking around, tests the mettle of the emergency medical responders.

"It's the most complex, dynamic and challenging place I've ever worked," said Troy Harnish, who has been a flight paramedic for 15 years, all over Canada and in the Middle East.

Harnish said its a monumental task, keeping patients warm and equipment from freezing up, when the mercury dips as low as -51 C.

Harnish recently basked up some warmer weather, completing an exhaustive two-week training program in Orlando, Fla. He came back with two certifications: the Flight Paramedic Certification and a paediatric and neonatal critical care certificate.

Harnish is one of only six flight paramedics in the country with the young child and infant certification.

In the NWT, Harnish said 30 per cent of the calls Medic North receives deal with kids and infants, compared to the one per cent rate for the rest of Canada.

With the high volume of calls for young kids - five of the last 10 calls they received as of Thursday were for infants or young kids - Harnish says he will definitely benefit from the course.

"When kids turn sick up here, they turn sick in a hurry," he said. "Kids will fool you all the way up until they are ready to die."

He explained if a grown person's heart is pumping at half capacity, they will show grave symptoms and signs. Children, however, do not exhibit these symptoms as dramatically.

"You have to be a little more of a detective," he said.

He said the course taught him to ask more questions early on in diagnosis.

Cross, along with Medic North president and CEO Sean Ivens, said Harnish's accomplishments should not go unrecognized.

"The people of the North are pretty lucky to have someone of that calibre providing them medical services," said Ivens.

The job takes it toll on the flight paramedics, who work a three-day on, two-day off rotation.

Medic North has four full-time staff in Inuvik, nine in Yellowknife and seven casuals in the capital. The medevac service is provided 24 hours a day, seven days a week, 365 days a year.

Cross said paramedics lives must be adjusted around the instant call to duty.

"It's not uncommon in the 72-hour window to be active for most of it," he said.

Harnish said he has grown accustomed to the on-call aspect of the job.

"We take two cars to the restaurant," he said, when he goes out to eat with his family.

Harnish estimated he spends 650 hours a year in the air, 1,400 hours on missions and another 700 hours on furthering his education and training.

Medic North - covering all of the NWT, and portions of Nunavut, British Columbia and Alberta when demand calls - received over 1,000 calls from the Yellowknife base last year, said Cross.

"This year, we are on pace to exceed that," he said.

The hard work is worth it though, they say.

"It's a privilege sharing in monumental moments in peoples' lives," said Cross. "There are no words that I know of to reflect the appreciation we get from family members."

Harnish agreed.

"We see people on their worst days," he said. "It's satisfying to take someone's worst day and roll it over into something positive."

"The stakes are high. Lives are on the line," said Cross.

"There is no greater calling that I can think of and that's why people want to come here."

During the interview on Thursday morning, two of the three King Air planes were out on missions. As the interview concluded, the fax machine fed out a paper.

And with that, the third aircraft was called out for a medevac.