· In short: A paramedic has told a coronial inquest of her distress while waiting with patient Bernard Skeffington, who died after being ramped in an ambulance.

· The inquest is investigating the death of Mr Skeffington and two other patients who were impacted by ambulance ramping in South Australia.

· What's next? The inquest is expected to continue over the next fortnight.

A paramedic has told an Adelaide court of her despair at feeling "powerless" while waiting with a deteriorating patient who was ramped outside the Royal Adelaide Hospital (RAH).

Paramedic Stacey White was with patient Bernard Anthony Skeffington, 89, while he waited in an ambulance for an hour and 43 minutes outside the hospital before being taken inside to the emergency department in peri-arrest.

"It was clear to us that he required urgent assistance," Ms White said.

A coronial inquest into Mr Skeffington's September 2021 death is also considering the deaths of two other patients, who were also impacted by ambulance ramping.

Before he was ramped, two ambulances were re-tasked before a third ambulance was dispatched to Mr Skeffington — three hours and 43 minutes after his first request.

Ms White told the court it was distressing to be ramped with Mr Skeffington as his condition worsened and he experience nausea.

She said she was left alone with the patient while her colleague went inside "with a specific view to have Mr Skeffington accepted into the [emergency department] due to the deterioration of his condition".

As Ms White waited, she said Mr Skeffington experienced "explosive" vomiting, which she said suggested a twisted bowel or obstruction.

"I could not reach the radio to radio for help, I felt completely powerless to assist Mr Skeffington," she said.

"It was an awful feeling, I banged on the ambulance windows in an attempt to attract attention of the other paramedics nearby.

"I believe I did everything that I possibly could in that situation."

Mr Skeffington died four days later from aspiration pneumonia secondary to a small bowel obstruction. He had been transferred into comfort care.

The inquest is also investigating the deaths of 76-year-old Anna Vincenza Panella in April 2019 and 64-year-old Graham Henry Jessett in March 2022.

Ms Panella was ramped for 50 minutes before being taken into the RAH emergency department, while the court has heard Mr Jessett spent five hours waiting for a hospital bed while ramped at Flinders Medical Centre.

On Monday, registered nurse and former RAH triage nurse Jenese Heywood was on duty when Ms Panella arrived at the hospital.

She told the inquest she started working elsewhere due to the impacts of ramping on her role of triaging patients who arrived at the emergency department via ambulances.

"[Ramping] was an everyday stressful occurrence," she said.

"It made my job very hard and it was actually one of the reasons I left."

The inquest into the three deaths is continuing.