SA Ambulance Service Chief Executive David Place reportedly sent a letter to paramedics yesterday with a warning they may be guilty of “misconduct” if they made unauthorised comments to the media.

It comes after the SA Ambulance Employees Association went on a media blitz yesterday after all metropolitan hospitals went “code white” on Monday night, with 88 patients waiting for a bed and 15 ambulances ramped at the Royal Adelaide Hospital at around 8pm.

Code white is SA Health highest rating for the level of pressure on a hospital, indicating services and patient safety could be compromised by the situation.

Paramedic Josh Cox said he worked a 12-hour shift with no break on Monday.

“The first patient we transported, we were stuck on the ramp for four hours before we were able to have them seen by a doctor,” Cox told reporters yesterday.

“Throughout the entire 12-hour shift, there were uncovered lights and sirens jobs that we just did not have resources to send.

“People need to know that the community is at risk, there are delays in getting ambulances out to the public.”

Cox also said he believes the state is “one large scale motor vehicle accident away from a catastrophic event”.

Opposition Health spokesperson Chris Picton said this morning that the problem has become “much, much worse” under the current government.

“How many paramedics have to warn Steven Marshall and Stephen Wade of the risk to the community before they take action?” Picton said.

“Rather than gagging paramedics, the government should be listening to them.

“It is simply frightening to hear reports of Triple Zero emergency callers not receiving an ambulance.”

Premier Steven Marshall told reporters on Tuesday that the government takes the issue “very seriously”, and said they were looking at a range of solutions – from ambulance resourcing to hospital patient flow – to solve the problem.

“The ramping is unacceptable, it’s not something that we are sitting on our hands about,” Marshall said.

“But there’s no simple solution to the situation that we inherited from the previous government.”

He added that ongoing upgrades to the Flinders Medical Centre had temporarily reduced the facility’s emergency department capacity.

“One of the things that is compounding the problem at the moment … is that there has been a slight contraction at the ED capacity at the Flinders Medical Centre which is putting some pressure on the overall system at the moment.

“But we are working to get that stood up as quickly as possible.”

The premier also pointed to the more than 180 paramedics his government has hired, and the upgrades completed on 46 ambulances across the state’s health network during his time in office.