Post-traumatic stress disorder (PTSD) is a severe psychiatric condition resulting from exposure to intense stress or traumatic experiences, particularly prevalent among emergency medical services (EMS) providers. This study assessed the prevalence and determinants of PTSD among frontline paramedics at the Saudi Red Crescent Authority (SRCA) across various regions of Saudi Arabia. A total of 409 paramedics, selected using a stratified sampling technique for regional and gender representation, participated. PTSD was assessed using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). Invitations were sent via email within SRCA facilities, and the study was conducted online to ensure wide participation. Ethical approval was granted on December 12, 2023.

The sample was predominantly male (95.6 %) and aged 30–39 years, with most holding a diploma or college degree. Emergency medical technicians (EMTs) constituted 72.1 % of the sample, and 64.8 % had over 10 years of experience. The overall PTSD prevalence was 49.6 %. Logistic regression analysis identified significant associations between PTSD prevalence and occupation, as well as years of experience. EMTs had higher odds of experiencing PTSD (adjusted OR = 1.85), and those with more than 10 years of service showed an increased likelihood of PTSD (adjusted OR = 1.45). The most notable PTSD symptoms were negative changes in perception and mood, followed by hyper-arousal and re-experiencing traumatic events.

These findings highlight the high prevalence of PTSD among SRCA paramedics and underscore the critical need for targeted mental health support and interventions to enhance the psychological well-being and resilience of paramedics.