This study identifies factors associated with the successful integration of ambulance volunteers and first responders into major ambulance services in Australia and New Zealand, and then proposes a model of volunteer management for ambulance services.All ten members of the Australasian Council of Ambulance Authorities completed a questionnaire describing their volunteer and first responder staff, their numbers and deployment, and the management and integration of volunteers within their respectiveorganisations. Eight senior managers responsible for ambulance volunteers and first responders from six States of Australia and one region of New Zealand subsequently participated in semi-structured interviews. Analysis of interview transcripts and publicly available data revealed facilitative factors associated with strong, vibrant ambulance volunteer systems. These facilitative factors are: commitment to volunteer models of service delivery; a degree of management decentralisation and volunteer input into decision-making; commitment of resources toward the volunteer model; and the organisational integration of volunteers into the ambulanceservice. The proposed facilitative model of volunteer management developed aims to encourage the adoption of positive and innovative strategies to improve the integration of ambulance volunteers and first responders in ambulance services. The model consists of fourcomponents: leadership; integrative processes; resource commitment; and relative autonomy. The first three of these relate directly to the organisation, while the fourth concerns the volunteers themselves. If these approaches were replicated more widely, a viable andeffective volunteer emergency health response system could be established in those areas where it is uneconomic or impractical to provide a salaried ambulance service staffed with professionally qualified paramedics.