Assaults on paramedics and ambulance staff have risen, according to a report.
West Midlands Ambulance Service (WMAS) recorded an increase of more than 60% in verbal assaults in the region.
The Local Democracy Reporting Service said incidents where staff have been physically assaulted were found to have increased by 23% since last year.
WMAS said the increase in attacks was "extremely disappointing" and "beggars belief" when staff are trying to help.
The report, published by the ambulance service, said there were 80 reports of physical assaults against staff during April and May this year with 165 being verbally abused.
This compares to 65 physical assault reports and 102 verbal abuse reports for the the same two months in 2018.
In total, the service recorded 432 physical and 634 verbal assaults against staff in 2018.
Security incidents - which cover damage to property - decreased by 21%, however two of the service's ambulances were vandalised in one weekend earlier in June, which are not included in the latest data.
Five workers were also assaulted that weekend in Birmingham, Telford and Redditch.
The West Midlands service was found to have the most vandalism attacks out of all of the UK's providers, with 36 incidents between January 2015 and October 2018.
In May, it was announced crews would be given body cameras after it emerged that two out of every five paramedics in the region had been attacked.
WMAS said it "works extremely hard to bring the full weight of the law to bear on anyone who attacks our staff".
Paramedic Natasha Starkey previously told the BBC attacks on staff are "expected".
She said: "I've been spat at, I've been punched, I've been shoved against the ambulance, had sexual comments passed to me."
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