Paramedics are being assaulted as they try to treat drunk and drug-fuelled patients, and the consumption of drug ''cocktails'' is forcing paramedics into increasingly unpredictable and volatile situations.
Five paramedics have been assaulted on the job every year for the past three years. A total of 21 ambulance officers were assaulted in the past five years, but that figure may not include less serious assaults that go unreported.
The assaults have sucked $440,000 from the ACT Ambulance Service's budget in workers' compensation claims for loss of salary, medical costs, examinations and rehabilitation.
Ambulance Service deputy chief officer David Dutton said while not all assaults were alcohol or drug related, patients who were drunk were more prone to turn violent.
''We accept that our work involves dealing with a whole range of people across the community at their very best and very worst,'' Mr Dutton said.
''Sadly it is a reality of life that there are some people who are unappreciative of our efforts or other's efforts to help them.''
Some assaults have occurred in the back of ambulances, as paramedics try to treat patients on stretchers.
Mr Dutton said there were strong measures in place to protect paramedics caught in danger. The service warns its paramedics to quickly withdraw from cases that become volatile and alert police.
But Mr Dutton said the mixture of different drugs and alcohol were making some cases wildly unpredictable, and catching paramedics off guard.
''Where you start getting a cocktail of different mixes, so some alcohol and some drugs, some of which you might know about, some of which you might not, they tend to be the people that can be quite unpredictable.''
In April, the Victorian government introduced tougher jail sentences for assaults against paramedics, police and other emergency workers.
Western Australia introduced similar sentencing reforms for emergency workers in 2009 and there have been calls for tougher prison terms in Tasmania and Queensland recently.
Mr Dutton said the service had managed to mostly avoid serious injuries from the 21 attacks.
But paramedics were often affected psychologically and physically.
Mr Dutton said paramedics were also at potential risk when called to domestic violence incidents.
''We shouldn't unfairly paint the pubs and clubs as the only place violence can happen,'' he said.
''But we would certainly on a Friday and Saturday night … be spending a large amount of time in the Civic precinct or in other areas where there's hotels and licensed premises.''