A 21-year-old man has been charged with murder following the fatal stabbing of a paramedic outside a Campbelltown fast food restaurant in Sydney's south-west.
Police officers were called to the incident at McDonald's in Queen Street about 5:30am on Friday after the paramedic's colleagues activated a duress alarm.
The male paramedic, 29, was treated at the scene before being rushed to Liverpool Hospital, where he later died, police said.
The paramedics were taking a break at the restaurant after working through the night, NSW Ambulance said.
A 21-year-old man was arrested at the scene and taken to Campbelltown Police Station.
He was charged with murder on Friday evening and was refused bail. He is expected to appear at Parramatta Local Court on Saturday.
NSW Ambulance Commissioner Dominic Morgan said the man's death was a tragic loss.
"You can imagine this is an extremely difficult time for his young family and the NSW Ambulance broader family," he said.
"I had the privilege of meeting with his mother and father, wife and sister who as you can imagine are beside themselves after this tragic loss.
"Personally it's very difficult to process any person just going to work to do their job, let alone a paramedic who puts themselves on the line, to not come home is a tragedy and almost inconceivable to work through on any level."
NSW Health Secretary Susan Pearce broke down in tears as she paid tribute to the man and his team of paramedics.
"The health system is one big family and to lose someone in this way is incomprehensible to us."
Premier Chris Minns also paid tribute to the paramedic and other ambulance workers.
"Our hearts go out to him and his family and all paramedics across New South Wales," he said.
"I say to all paramedics in New South Wales today, who after hearing this news put on their paramedic uniform and serve the people of New South Wales — thank you for your dedication."
Health Services Union NSW secretary Gerard Hayes said it was a "profound tragedy".
"We extend our deepest sympathy and support to the family and colleagues of this young paramedic," he said.
Man tasered at scene
Earlier on Friday, police were asking for anyone who may have information regarding the incident to come forward.
"On arrival [at the scene], police were confronted by a 21-year-old man," NSW Police Deputy Commissioner Mal Lanyon said.
"In order to render assistance to paramedics on the scene, police were forced to use a taser and subsequently arrested that 21-year-old male."
Police established a crime scene in the restaurant car park, with police tape surrounding two ambulances and shoes and clothing strewn on the ground.
Temporary shelters were set up to protect potential evidence from the rain, including a tarp covering the front of an ambulance.
Officers on the scene asked people to avoid the area, telling passers-by the McDonald's was closed.
Passer-by Leanne Cameron said she was shocked by the attack.
"[It's] disgusting, they're [paramedics] here to help us," she said.