Queensland ambulance workers say they may take industrial action if there is no agreement on a new pay deal.
The Liquor, Hospitality and Miscellaneous Union (LHMU) said paramedics were asking for a six per cent annual pay increase over three years.
But the state government was offering only 3.25 per cent a year.
LHMU ambulance section state organiser Jason Dutton said the offer was almost two per cent less than inflation and was an insult to paramedics struggling under the pressure of fatigue and low pay.
"We don't take industrial action lightly and we're hopeful it won't get to that point, but our members are taking this matter very seriously," Mr Dutton said.
But any industrial action taken would not affect public safety in any way.
"Paramedics never target the public who pay for and appreciate our service," Mr Dutton said.
"We target the government that expects us to take a pay cut in real terms."
Mr Dutton said paramedics had taken on increased roles previously the preserve of hospital emergency staff, such as the administration of certain life saving drugs, but there was no increase in pay to reflect the extra responsibility.
"Paramedics are often under pressure to work long hours, skip meals and stay on-call in their time off to service Queensland's rapidly increasing population.
"A pay cut in real terms will mean even more paramedics will leave the service leaving public health at even greater risk."
The final round of negotiations will be held Wednesday.
