WAGGA paramedics won't touch cases where people are affected by ice until police backup arrives at the scene, citing fears for their safety.
Ice is a problem paramedics now find themselves grappling with daily.
Those affected by the drug typically exhibit violent and unpredictable behaviour, often turning already difficult situations for paramedics into nightmares.
If police are delayed arriving at jobs involving ice, paramedics will wait rather than put themselves in harm's way, according to NSW Ambulance Service's Murrumbidgee zone duty operations manager Eamonn Purcell.
"If (police) are busy, we have to wait," he said.
"At the end of the day, the safety of our paramedics is something we have to consider as more important."
Paramedics have had to deal with drug-affected patients for decades, but the recent rise in the popularity of ice has been a game-changer.
Previous flavour of the month 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," Inspector Purcell said.
Paramedics are now treating any job involving people affected by ice as a potentially violent situation due to the extreme impact the drug has on those who take it.
"We do hang back and wait when there's a suggestion of violence and drug use involved," Inspector Purcell said.
"Because ice promotes aggressive, paranoid and irrational behaviour, we're more aware the scenes we're going to are increasingly violent."
That violent nature promoted by ice has led to a number of incidents in recent months around the Riverina that have ended in paramedics being assaulted.
In December, a paramedic was assaulted by a patient who was suspected to be under the influence of drugs in Albury. That paramedic has yet to return to work and according to Inspector Purcell, that remains a case of if, not when.
Paramedics often 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 what's happening at the scene."
There has been a steady rise in the number of cases involving drugs that paramedics have been called out to in the past two years, with a noticeably sharp increase in the last six months.
THE emergency department at Wagga Base Hospital has seen a surge in patients under the influence of ice in the past six months.
That revelation comes as paramedics struggle to deal with a rapidly increasing number of call-outs to situations involving ice users in the same timeframe.
Despite the increase in ice-affected patients arriving at emergency in Wagga, department director Shane Curran said procedures were in place to ensure the safety of both staff and other people seeking treatment.
"We're aware of it, we're prepared for it and we can resource it," he said.
"Everybody in the emergency department should feel safe."
Dr Curran said staff safety was "paramount" in the department and resources were available to deal with aggressive and unpredictable patients, including those affected by ice.
"(There are) multi-disciplinary procedures to manage all presentations to the emergency department," he said.