Paramedics say ambulance ramping is causing them "widespread and undeniable psychological injury", and warn if nothing is done to address their concerns "the consequences could be catastrophic".

Key points:

Paramedics say ambulance ramping is affecting their mental health

Paramedics say ambulance ramping is affecting their mental health One paramedic says he knows of a numbers of cases where treatment delays could be related to deaths

One paramedic says he knows of a numbers of cases where treatment delays could be related to deaths Paramedics have made six recommendations to Ambulance Tasmania

In a letter to Ambulance Tasmania (AT) CEO Neil Kirby, paramedics in the state's south describe ambulance ramping and overcrowding at the Royal Hobart Hospital (RHH) as an "unmitigated crisis" that is "entirely unworkable" and affecting the mental health of frontline staff.

"Ambulance Tasmania is in a state of utter disarray with the psychological impact of ramping affecting paramedics in the extremis," said the paramedic who wrote the letter on behalf of his southern region colleagues.

"I hold genuine and immediate concern for the welfare of my colleagues and fear that without swift and decisive intervention the consequences could be catastrophic."

Paramedics say they are experiencing anxiety, insomnia and are being reduced to tears due to stress.

Earlier this month, executive emergency department registrar doctors wrote a scathing letter to the Tasmanian Health Service executive warning of "direct patient injury and death" because of worsening conditions and bed block.

A paramedic the ABC has named John to protect his employment said morale among frontline AT staff was at an all-time low, and people were dying after delays accessing hospital care.

"There are actively people seeking jobs in other services because they are so depressed at work," he said.

"Some people have said they are considering self harm because of how ambulance work is in Tasmania at the moment."

John recently spent 11 hours of a 13-hour shift waiting with a patient who needed to be admitted to the RHH's emergency department.

"There has been a number of cases I'm aware of where patients have had delays to treatments that may have related in patient deaths or worse patient outcomes," he said.

"That may be as simple as delay to antibiotics in patients that have severe infections, which we know causes an increase in mortality rates."

He said a patient recently transferred from the state's north with a known abdominal aortic aneurysm requiring surgery was ramped at the RHH for hours, until their vessel burst, requiring life-saving surgery.

Do you know more about this story? Contact tasindepth@abc.net.au

Tasmania has the worst Code One ambulance response times in the country, and paramedics say they have worsened in the last six months.

John described the case of a six-week-old baby in Sorell triaged with a respiratory arrest who had to wait for an ambulance from Glenorchy, when there should have been several ambulances closer to respond faster.

"It makes us feel like we can't do our job, it makes us feel that when we arrive on scene our patients are sicker than they would have been, had we been able to arrive 15, 20 minutes or maybe hours sooner," he said.

Paramedics demand action from Ambulance Tasmania

The letter from Southern Region paramedics calls on Ambulance Tasmania to stop seeing ambulance ramping as a "hospital problem", saying not enough was being done by the organisation to manage the impact on staff.

The letter makes six recommendations, including ensuring paramedics are not subjected to more than two hours of continuous ramping, a ban on staff overtime due to ramping, and for the appointment of a co-ordinator of ramping for the southern region.

"Staff are routinely pressured into clinical situations which are unsafe and inappropriate, with reported safety issues being routinely dismissed or ignored," it states.

John called for more funding to address the issues faced by paramedics.

"I believe that greater funding to improve our equipment, clinical governance and the number of crews on road is urgently needed in Ambulance Tasmania to provide the response the public expects," he said.

Health And Community Services Union state secretary Tim Jacobson echoed the issues raised by paramedics in the letter to Ambulance Tasmania.

"Clearly we have to take these comments very seriously, and immediate action must be taken to ensure our paramedics are not in the circumstances that they are in right now," he said.

A spokesman from Ambulance Tasmania said the organisation was happy to consider staff input.

"Ambulance Tasmania received a letter from a staff member today [Tuesday]. As always, we are happy to consider staff input, and are continuing to work with the Tasmanian Health Service regarding demand pressures on the emergency department," he said.