Rioting youths threw missiles at ambulance crews as they tried to help people injured in the violent disorder that spread across London last night.

Across the capital 22 people were taken to hospital, with many more treated by paramedics at the scene and more reported to have made their own way to the emergency departents.

The violence and looting, which was sparked after police shot and killed Mark Duggan last Thursday, also spread to other parts of the country last night.

London Ambulance Service director of operations Richard Webber said this morning: “It was an incredibly challenging night for everyone involved, but all the staff working in our control room, support departments and on the frontline worked very professionally to help us reach patients as quickly as we could.

“On some occasions, this was made even more difficult as missiles were thrown at our vehicles and crews were threatened and intimidated while trying to care for people.

“We will be continuing to regularly review the situation across the capital in order to ensure that we can respond to calls while maintaining the safety of our staff.”

In Birmingham, West Midlands Ambulance Service was called to 34 incidents related to the disturbances between 8.30pm and 3am.

Of these, 13 patients were taken to hospitals across the city. Injuries included lacerations and bruising to the head, a dislocated knee, general cuts, bruising and swelling.

Assistant Chief Ambulance Officer Tracey Morrell said: “The majority of incidents have been as a result of assaults, but thankfully most have not been too serious. However, the fact that over a dozen patients went to hospital gives you an indication of the levels of injury.”

In Liverpool, North West Ambulance Service was on standby for a major incident overnight but despite reports of hundreds of rioters storming shops and starting fires in the south of the city nobody was taken to hospital.

President of the College of Emergency Medicine John Heyworth told Nursing Times he had not received reports of accident and emergency departments being overwhelmed by causualties as a result of the rioting, as the disorder had been confined to the streets.