After Liz Cullen fell heavily at her central Queensland home, she pushed through excruciating pain to shuffle along the floor and pull herself up on one leg to reach her mobile phone and dial Triple Zero (000).
In tears because of the "10-out-of-10" pain in her right knee, the 63-year-old, who lives alone, expected she may have to wait a couple of hours for an ambulance after she was told paramedics would get to her "as soon as possible".
An ambulance never came.
Liz Cullen waited more than 12 hours after calling Triple Zero in September before a paramedic arrived in a 4WD. (ABC News: Russel Talbot)
"They were all ramped at the hospital, that was the problem," Ms Cullen said.
She is one of many people affected by Queensland's ongoing ambulance ramping crisis — when paramedics wait with patients for more than 30 minutes before their care can be transferred to hospital emergency department staff.
The issue not only affects patients on the ramp — it also prevents paramedics from reaching other people in the community.
Twelve-hour wait
An independent review has been promised into the death this month of 51-year-old Nick Bradford in Brisbane.
Mr Bradford, who also lived alone, phoned for an ambulance complaining of chest pains. By the time paramedics arrived more than two hours later, he was dead.
Twelve hours after Ms Cullen's initial Triple Zero call on September 12, a senior paramedic driving a Queensland Ambulance Service (QAS) 4WD pulled up outside her Rockhampton home.
He had no stretcher but by that stage, she was willing to "get to hospital any way I could" after the lone paramedic told her an ambulance was still hours away.
"He was very apologetic," Ms Cullen said.
Liz Cullen consulted a private orthopaedic surgeon after she tore her meniscus, which required surgery. (ABC News: Russel Talbot)
Unable to walk, Ms Cullen was wheeled to the 4WD in an office chair and driven to Rockhampton Hospital.
By that stage, Ms Cullen's daughter was with her.
In the hours before the paramedic arrived, her daughter was able to help her to the toilet and bring her a glass of water.
But getting her mother out of the house was too much.
"I was in so much pain, and I have a little lip to get over at the front door," Ms Cullen said.
Ms Cullen with the office chair used to wheel her to a 4WD to take her to Rockhampton Hospital after she fell and tore her meniscus. (ABC News: Russel Talbot)
When she finally got to hospital, the senior paramedic had to double park and find a wheelchair so he could take Ms Cullen inside.
There, she said she was met with stretchers and paramedics lining both sides of the emergency department and down a hallway.
"Out in the actual waiting room, it was choc-a-block full as well," Ms Cullen said.
"There were people getting quite angry out there that had obviously been waiting a while, too. I think it's just too busy in that emergency department."
More than 39 per cent of patients at the Rockhampton hospital were ramped for more than 30 minutes in August. (ABC News: Russel Talbot)
Ms Cullen ended up staying three nights in hospital with a torn meniscus — damage to cartilage that protects the knee joint — which required surgery.
"I was assessed by a physiotherapist who said that they couldn't send me home because I lived alone and I couldn't weight bear," she said.
She was operated on privately earlier this month.
Patients fending for themselves
About 1,000km north, in Cairns, former nurse Jill Knell, 71, took herself to her local Medicare Urgent Care Clinic at 9pm on October 15 after feeling unwell most of the day.
There, her blood pressure was tested several times at 220/100 — a reading she describes as "a medical emergency".
"It can be life-threatening because it could be indicative of a stroke, a heart attack, an aneurysm, or acute kidney failure," Ms Knell said.
Ambulance ramping outside Cairns Hospital this month. (ABC News: Brendan Mounter)
The doctor gave her some blood pressure lowering tablets and phoned an ambulance about 9:50pm, 10 minutes before the clinic closed.
"There was a nurse and a receptionist and doctor. None of them could go home because they couldn't leave me," Ms Knell said.
She told them she could wait in her car for the ambulance to come but the staff said they would wait with her.
More than two hours later, it still had not arrived.
At midnight, when the QAS could not give the doctor any indication of when an ambulance would be sent, he put Ms Knell, who also lives alone, in his own car and drove her to the Cairns Hospital himself.
They arrived about 20 minutes past midnight.
The Urgent Care doctor handed her over to emergency department staff and requested that she be able to lie down, but there were no beds.
"I was told there could be a significant wait as there was severe ambulance ramping but that I should not leave," Ms Knell said.
An Urgent Care Clinic doctor drove Jill Knell to the Cairns Hospital himself after waiting more than two hours for an ambulance. (ABC News: Brendan Mounter)
Outside of Brisbane, Cairns Hospital is one of the state's worst hospitals for ambulance ramping.
In August, the latest data available, 45.6 per cent of patients arriving by ambulance were ramped — worse than the August before the Crisafulli government came to power in 2024, when it was 37 per cent.
Ms Knell had her blood pressure checked about 20 minutes after she arrived at the emergency department, a nurse drew blood, and she had an electrocardiogram (ECG) to test the electrical activity of her heart. She was also given a strong painkiller.
"I was then left alone in a chair in the chaotic waiting room unmonitored for nearly two hours," she said.
"I was feeling seriously unwell, had a terrible headache, was nauseous, exhausted and had palpitations."
At her request, a nurse checked her blood pressure again at 2:50am.
Ms Knell says she was never assessed or treated by a hospital doctor at the Cairns Hospital emergency department after arriving with extremely high blood pressure. (ABC News: Brendan Mounter)
Ms Knell was feeling "even more nauseous, woozy and desperate to lie down" but her blood pressure had gone down.
At 3:20am, about three hours after arriving at the hospital, she had another blood pressure check with a similarly lower reading, then discharged herself without seeing a doctor "due to the distressing waiting room environment and the anticipated long wait ahead".
She consulted her own general practitioner (GP) later that day, who ordered a brain scan to check for signs of a stroke, and has been under the GP's care since.
Blame directed at system
A Far North Queensland-based paramedic, who wanted to remain anonymous, said he was "genuinely worried about the consequences" of hospital ramping on the region.
"I fear it is only a matter of time before a patient falls through the gaps in the system and suffers a serious adverse outcome, potentially resulting in death," he said.
"It is deeply troubling to feel that it may take a preventable tragedy before meaningful action is taken."
Both Ms Knell and Ms Cullen are not angry at the individuals who cared for them.
"The ambulance and medical staff as individuals were absolutely doing their best in an obviously failing, unsustainable and unacceptable environment," Ms Knell said.
Both women have written letters of complaint to their regional public hospitals.
"It's the hospital system that I blame," Ms Cullen said.
A QAS spokesman said the service was "committed to delivering the best care possible and will always prioritise the sickest patients first".
He said both patients were assessed based on the information provided and "received appropriate clinical oversight" during what were very busy periods.