A paramedic admitted today that "precious time" could have been "wasted" as medical teams waited above ground for an update on casualties in a Tube train bombed in the 7/7 attacks.
The first two paramedics who went down to the wrecked carriage at Aldgate station in London carried no medical equipment because they did not want to be distracted from their assessment work, the inquest for the 52 victims heard.
Because their radios did not work underground, they both had to return to the surface to request life-saving supplies, the hearing was told.
In the bombed carriage, paramedics David Parnell and Steve Jones found six dead bodies and seven or eight seriously wounded survivors they classed as "priority one", meaning they needed immediate medical help.
Mr Parnell returned to the surface to tell waiting medics what was needed to treat the injured on the train.
He was still talking to his colleagues when Mr Jones came up from the tunnel to ask what had happened to the medical team and extra equipment they had asked for, the inquest heard.
Mr Parnell, who in 2005 was part of a doctor and paramedic emergency team based at the Royal London Hospital in Whitechapel, east London, was designated "bronze medic" on arriving at Aldgate with responsibility for working with the other emergency services to save as many lives as possible.
He said he did not take medical supplies down to the train at first because his task was to assess the situation.
"As a bronze medic, if you take medical kit with you, you start treating people," he said.
"So my experience is from listening to other medical personnel who have done major incidents and have actually done a role of bronze medic, the best thing to do is take a pen and a pad."
Coroner Lady Justice Hallett questioned him about the apparent delay in treating the wounded on board the train.
She asked: "Did you know, Mr Parnell, why the medical teams weren't immediately behind you?"
The paramedic replied: "At this stage we didn't know what we were dealing with. "It is standard procedures that a bronze medic would give a full report and state what's required and what kind of equipment is required before a medical team is committed."
The coroner went on: "Here you have to run back. If you're waiting for that, isn't there the possibility that precious time could be wasted?"
He replied: "That is a possibility."
Mr Parnell said he believed that only one paramedic - a man called Craig Cassidy - was left in the bombed carriage when he and Mr Jones came to the surface to request more assistance.
He said: "According to records, I now know that Mr Cassidy was there."
On arriving at Aldgate, Mr Parnell told other paramedics to stay at the surface, the inquest heard.
This was to ensure that the ambulance "silver commander" in charge of the incident knew where all medics were in case another bomb went off on the train.
He explained: "It is standard practice that silver knows exactly how many have gone down to the incident site, and should there be a secondary device he or she would know how many resources are at that site."
Mr Parnell said he went between the surface and the bombed carriage three or four times, a journey that took three to four minutes each way.
The inquest also heard that there was confusion about who was in charge of the emergency medical response at Aldgate.
Three ambulance officials independently called their control room to declare the bombing a "major incident".
The coroner remarked: "If you weren't careful, you would find everybody arriving would be trying to ascertain the situation and there wouldn't be anybody attending to casualties."
Mr Jones told the inquest he was only carrying triage cards, used for marking how urgently injured people need medical help, when he descended to the train.
"I deliberately didn't take any medical equipment, otherwise I would be drawn into treating patients," he said.
Hugo Keith QC, counsel to the inquests, asked him: "In this plan whom did you envisage would provide first aid, if any, to the people on the train?"
The paramedic replied: "I understand it may seem strange for us not to take medical equipment when that's what we're trained to do.
"The short time it takes for us to triage will actually benefit in the long term by finding out what injuries there are and what equipment is needed on the train."
Lady Justice Hallett asked him: "Doesn't that depend on how soon afterwards those who are going to be in a position to treat, as it were, follow you down?
"I mean, presumably, if you're triaging in an emergency situation, you assume there's going to be somebody right behind you."
He replied: "Yes, my lady."
Mr Jones disagreed with Mr Parnell's account of how many paramedics were left in the wrecked carriage when he came to the surface to request more help.
He said there were between four and six medics when he left the Tube train, not one as Mr Parnell recalled.
"I would not have left the train without ambulance crews on the scene," he said.
Mr Jones accepted that he asked for more paramedics to be sent to the carriage - but said this was wrong and what was really needed was extra stretchers.
He said: "On reflection, I didn't need any medical teams downstairs. What I needed was equipment to move the patients.
"But I quite possibly did actually say I needed more medical teams, which I was incorrect in doing so."
Mr Jones, who in 2005 was a motorcycle paramedic based at Waterloo ambulance station, also described problems getting stretchers out of an emergency equipment vehicle sent to the scene.
He said: "The person driving it didn't know how to open the doors, I was having problems opening the door and wasn't entirely sure what equipment was on board."
But he added: "In reality, I don't think it did delay things very long."Reuse content