That's what Luke Kelly was faced with last year when he was called to a riot at the Kariong Juvenile Justice Centre.

The former Orange man currently works as a special operations paramedic on the Central Coast. This means he often works as a medic to assist the police force's tactical operations team.

On July 21, 2019, when more than 30 inmates had obtained keys and armed themselves at the juvenile centre, Mr Kelly was there.

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"It went for 22 hours and they almost broke out of the centre," he said.

"We were called in during the time when prisoners said that they had hostages.

"Around 20 people from outside the prison also arrived on the scene to help break them out."

The first crews arriving on scene were confronted with facility staff requesting urgent medical support for severely injured juvenile inmates.

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Despite limited information regarding the security of the facility and the nature of injuries, they entered the complex and commenced triage and treatment.

"There's two of us assigned to that police unit every day and we had to get on the roof and treat the injured the inmates," Mr Kelly added.

"I felt reasonably safe because we had two of us among ten tactical operators.

"We had full tactical protection as well, so we had bulletproof vests and helmets and stuff like that."

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Now, more than a year later, he has been recognised for his efforts that day.

He was recently presented with the Commissioner's Unit Citation for Courage.

The description of the citation read: "Despite the substantial risk of injury to themselves and with disregard to the effects of the riot control agent, the paramedics performed above the expectations of NSW Ambulance in a very complex and extremely hazardous environment.

"They provided six juvenile patients quality clinical care for injuries; that included head injuries, fractures and multiple stab wounds."

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Mr Kelly, who still has family in Orange and comes back to the area every few months, said it felt good to be recognised.

"I was surprised and felt pretty humbled by it," he said.

"I've been doing the job for nearly 13 years and I've done a lot of dangerous work, so it was nice to get an award."

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The award itself is given to a group who, under hazardous circumstances, collectively display courage of a high order beyond that of expectation, while consciously placing themselves at substantial risk of injury.

But while Mr Kelly was more than happy to receive it, he isn't much for the limelight and was just happy to get the job done.