Ambulance Victoria has enacted its seventh code red escalation in as many months, with the service overwhelmed by demand overnight.
The code red was called just before 2am and was in place for about 90 minutes.
As part of the procedure, the ambulance service calls in additional off-duty staff, performs rapid offloading of patients at hospitals and sends non-emergency ambulances to respond to cases.
Ambulance Victoria's executive director of operational communications, Lindsay Mackay, said there were no extraordinary factors that led to the code red.
"There really wasn't anything that we could see that was different, other than we had a sudden surge in calls that came in just around midnight," Ms Mackay said.
"They just kept coming in for a couple of hours and that's really what led us towards activating the escalation plan."
Ms Mackay said many paramedics are absent from work as COVID spreads in the community.
"We are experiencing that as an ongoing challenge and with the flu season it will continue to be a challenge," she said.
Ambulance Union describes workforce in crisis
Victorian Ambulance Union secretary Danny Hill said the strain on the paramedic workforce had grossly impacted morale.
"I had a paramedic describe the situation at the moment as soul-destroying and I think that probably captures the feeling of a lot of paramedics," Mr Hill said.
"They're being asked to absorb a lot of the work from other parts of the health system that are also not coping."
Mr Hill said low morale and poor working conditions were leading many Victorian paramedics to be poached by ambulance services interstate or to change careers entirely.
"There's no question that we're looking at a lot of paramedics looking at leaving the job," he said.
A 2021 survey of Victorian paramedics found 74 per cent of respondents were thinking of leaving the profession.
Repeated code reds over past six months
Ambulance Victoria's first code red came just five days into the new year, as COVID-19 sidelined 500 paramedics and staff and left the service stretched thin over the holidays.
Another was called on January 11, with reports that 21 time-critical cases faced a delay in getting an ambulance dispatched to them.
Another escalation was called briefly on March 29, while technical difficulties with the dispatch system saw an escalation called for just over an hour on May 27.
One further code red was called this year, but Ambulance Victoria was unable to disclose to the ABC when it occurred.
The most recent code red came on June 28, with ambulances unable to meet demand for four hours.
In comparison, only nine were called between 2017 to 2021.
Ms Mackay urged Victorians to consider carefully whether they required an ambulance before calling for one.
"We are aware it's obviously not the first time we've called the code red," Ms Mackay said.
"For us it's around really asking the community to save triple-0 for emergencies."
She said Victorians could reach a range of telehealth services such as Nurse-On-Call (1300 60 60 24) to get medical advice instead of calling for an ambulance.
Acting Premier says ‘huge demand’ is on ambulance system
Acting Victorian Premier Jacinta Allan attributed the code red to unprecedented demand.
She said every health system around Australia is experiencing significant pressure due to the pandemic.
"That demonstrates huge demand that's being placed on our hardworking paramedics and ambulance staff."
Ms Allan said Ambulance Victoria's response was a credit to the staff and paramedics.
"Ambulance Victoria responded appropriately and quickly last night, using well-established normal practices to be able to call in, at short notice, additional staff," she said.
"They were able to move very quickly to minimise the amount of time that code red was in place."
Ms Allan said the state government is supporting Ambulance Victoria to recruit more paramedics.
She urged Victorians to get their fourth COVID vaccine dose to ease pressure on the health system.