A harrowing 24 assaults against South West NSW’s ambulance staff in the last year has prompted front-line workers to carefully consider their course of action when providing treatment. 

Ice has become a problem medics now find themselves grappling several times a day. 

After he was involved in an altercation with a drunken patient on New Year’s Eve, Gundagai EMT and NSW Paramedic Union secretary Gary Wilson has reached breaking point. 

He claims on top of a mounting tally of paramedics who report being abused, hit and bashed on the job – a further number keep the secret to themselves. 

“No one knows the true scope of it because most paramedics don't report,” he said.

“I wouldn't want to name the areas, but we select specific addresses and in every Riverina town there is a number of addresses where paramedics will be very cautious.

“Unfortunately, it’s been steadily increasing over the past decade and it’s really restricting the help we can offer.” 

Those affected by the drug typically exhibit violent and unpredictable behaviour, often turning already difficult situations for paramedics into nightmares.

NSW Ambulance Service's Murrumbidgee zone duty operations manager Eamonn Purcell said the safety and well being of emergency services ultimately took priority. 

"If (police) are busy, we have to wait," he said.

"We do hang back and wait when there's a suggestion of violence and drug use involved.”

Paramedics have had to deal with drug-affected patients for decades, but the ever increasing prominence of ice has made matters more difficult. 

Other substances, such as heroin, typically lulled addicts into a calm state or unconsciousness, which Inspector Purcell labelled as a situation that was much easier to deal with.

Patients affected by ice, however, present a radically different challenge.

"Ice patients are aggressive and agitated and require chemical and mechanical restraint to even get anywhere near them,” he said.

Sometimes they don't discover they're dealing with a job involving ice until they arrive on the scene.

"You don't always get that information," Tumut-based paramedic John Larter said.

"It's very difficult to ascertain over the phone.”

Anyone dealing with addiction can contact Alcohol Drug Information Service on 1800 422 599.