Recent attacks have led to calls for higher safety standards for NSW paramedics.

A paramedic was hospitalised after being punched by a patient she was trying to treat over the weekend.

It is one of the average 40 assaults that occur on staff at hospitals every month.

“It is certainly possible that someone could die at the end of the day,” Health Services Union Secretary Gerard Hayes told reporters.

“When people are being stabbed at a hospital, being shot in or around a hospital, when people are being punched in a hospital.”

Royal Prince Alfred Hospital security staff say violence is at untenable levels.

“We've had weapons turned on nursing staff, we've had a nurse held hostage with a knife to her throat,” security officer William Stratford said.

The Health Services Union wants an extra 250 security guards to be placed in NSW Hospitals and given special constable powers to search, restrain and detain aggressive patients.

On a normal day at the Royal Prince Alfred Hospital, there is around 20,000 people on site, but just four security guards in charge of protecting them.

Additionally, the guards have taken up industrial action in the form of four hour rolling stoppages.

The NSW government is bringing the matter to the Industrial Relations Commission this week.