Paramedics are increasingly facing a work environment that is "like a battlefield" while treating people in Hunter communities, the union representing NSW Ambulance officers says.
The state branch of the Australian Paramedics Association says ongoing assaults and verbal attacks on its members could mean paramedics stand off until police support arrives, if they do not feel safe attending a call-out without backup.
The union says paramedics should be off limits when it comes to physical and verbal abuse, but attacks on ambulance officers were "getting slowly but surely worse".
The comments come after a paramedic was allegedly assaulted while treating a patient at Mayfield on Monday.
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The female officer was in the back of the ambulance with the 32-year-old man when he became abusive and knocked her over.
She got out of the vehicle but the man allegedly followed her, hurling verbal abuse. Police have arrested the man and he will face court in May.
APA NSW president Chris Kastelan said instances of abuse towards paramedics appeared to have been becoming more common, in line with increased use of substances such as methamphetamine and ecstasy.
Mr Kastelan said ongoing assaults and abuse would make it more likely that fewer paramedics would attempt to treat a person in a situation that was possibly risky without support from police.
"Paramedics place themselves at the coalface to give the community high quality care when they're at their worst," he said.
"To think they could be the target of physical or verbal abuse at any time is a terrible blight on the community.
"It's just becoming like a battlefield for some paramedics to go out and treat their patients."