A union representing workers in the National Ambulance Service (NAS) has said the facility is on the "brink of bedlam" and the prospect of a nationwide strike is "extremely likely."
National Ambulance Service Representative Association (NASRA) chairman Michael Dixon said that industrial action from their some 400 members was "imminent" unless drastic changes took place "very quickly."
Mr Dixon has said that strikes could roll out as early as January with members to meet in the new year.
"At the moment, a strike looks like it could take place as early as January as there are many issues affecting staff in the service.
"In our eyes and in the eyes of our members the service is on the brink of bedlam," he said.
"Last month we had Minister Brendan Howlin blaming staff after a man sadly bled to death in Louth. He said short-notice staff absences were to blame for the fact that there were fewer ambulances on the road that night.
"There is a staff shortage of 200-people in the service, and that is currently down to him and the Government, not us."
Meanwhile, it's feared that large swathes of Leinster could be without ambulance cover over the busiest Christmas period. Text messages seen by this newspaper show management seeking staff to work in the coming days.
It has been claimed that up until Wednesday, no staff had been scheduled to man ambulance services in Monaghan between December 25 and 31.
Only one ambulance was scheduled for service between December 21 and 24 and into the new year. A single ambulance was also scheduled for service in Drogheda and Navan.
It's believed that an alleged blunder by management saw all staff who applied for annual leave for Christmas being granted the time off, leaving a massive void in the roster.
However, internal NAS memos viewed by the Herald reveal all leave was cancelled last Thursday.
Fears have been raised that a number of staff will take unauthorised sick leave, putting the service under serious strain.
In response, the HSE have said that "the NAS plans to cover all rosters over the holiday period" adding that no area will be hindered by a staffing shortage.
"There are no plans to take ambulances out of service," said a spokesperson.