One of the unions representing St John employees has issued a two-week industrial action notice.
If the New Zealand Ambulance Association's (NZAA) demands are not met, its members will stop doing remote triage, no longer respond to cardiac arrests on their own and cease using their personal phones for St John operational needs.
The union said the 14-day notice follows six months of stalled pay negotiations.
"NZAA sees these actions as the first of many and will be added to over the following months in series of industrial actions to force St John to come to the table and table a reasonable offer," union chairman Mark Quin said.
It said the strike action could result in some towns having no ambulance.
"NZAA will no longer single crew on operational ambulances and be able to respond to cardiac arrests on their own. St John has created First Response Units, ambulances with one officer on board due to staffing issues and St Johns refusal to recall staff, leaving single crewed ambulances around the country," Quin said.
"This will stop and the ambulance officer/paramedic left on station or assigned to another station as third crew. This will leave towns with one ambulance without ambulance possibly."
First Union, which also represents ambulance officers, have voted for a "media strike" ahead of this week's Budget as St John grapples for more Government funding.
Faye McCann, First Union's ambulance services national coordinator, said it had been "repeatedly told that a wage freeze is in place because Government funding isn’t sufficient for ambulance officers to receive any pay increase".
In a statement, Hato Hone St John said it couldn't discuss specific details about pay negotiations but continues to have "regular, constructive discussions with ministers, senior officials and our purchasers... about our financial situation and future funding requirements".
"Hato Hone St John continues to work in good faith and prefers to discuss relevant issues directly with unions.
"We are continuing the current collective bargaining process through mediation and hope to reach an agreement."
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