Ambulance ramping in Tasmania is causing “widespread and undeniable psychological injury”, paramedics say.

A letter to Ambulance Tasmania (AT) CEO Neil Kirby highlights ambulance ramping and overcrowding at the Royal Hobart Hospital (RHH).

Paramedics say it is an “unmitigated crisis” that is “entirely unworkable”.

“Ambulance Tasmania is in a state of utter disarray with the psychological impact of ramping affecting paramedics in the extremis,” said the worker writing the letter on behalf of 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.”

It comes just weeks after the Tasmanian branch of the Australian Medical Association (AMA) declared it had “no confidence” in Tasmania's health system management.

The letter calls on calls on Ambulance Tasmania to stop framing ambulance ramping as a “hospital problem”.

It 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”, reports say.

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

Health and Community Services Union state secretary Tim Jacobson said the letter raises many legitimate issues.

“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.

Ambulance Tasmania says it is 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,” a spokesperson said.