St John has doubled its Queenstown winter team from four staff to eight, saying local ski areas are predicting a 30% increase in numbers if the snow is good.
This season it will permanently station two new four wheel drive vehicles at Coronet Peak and The Remarkables skifields.
The Southern District Health Board is also taking on extra staff at Lakes District Hospital, particularly for radiology and administration.
SDHB patient services manager Lexie O'Shea said the number would be ''very few''.
Anticipation for winter has built with news of extra international flights to Queenstown, a new base building at The Remarkables and a relatively cold and wet May.
Skifield operator NZSki chief executive Paul Anderson said if there was good snow and both its Queenstown mountains opened on time ''we would forecast a record year''.
An increase in skiers and boarders will inevitably mean more injuries, raising concerns the hospital could be overrun.
''They [SDHB] have expressed concerns that if we don't deal well with our guest injuries on the mountain then they will be smashed - but we're doing our absolute best to make sure that doesn't happen,'' Mr Anderson said.
In 2013, ACC shelled out $18.5 million for skiing and snowboarding injuries.
This year, NZSki has outsourced medical services at its Queenstown fields to Australian company Medical Rescue, with a doctor, nurse and physiotherapist on hand at all times.
''It is a big ticket item,'' Mr Anderson said.
''We're prepared to make the investment to make sure our guests get the right primary care on the mountain.''
St John Queenstown station manager Keith Raymond said local ski areas were predicting numbers would rise 30% if the snow was good.
Much will depend on the skifields opening on time - Coronet Peak is scheduled to open on June 13 and The Remarkables a week later.
St John's eight extra winter contract staff, from all over New Zealand, start on June 15.
Mr Raymond said: ''We're gearing up for a long and potentially busy winter.''
St John responded to 451 snow sports injuries in the Queenstown Lakes region last year, about the same number as in 2013.
Mr Anderson described those two years as ''pretty average'' in Queenstown.
''We're due a big one.''
Earlier this year, Air New Zealand and Jetstar announced increased services to Queenstown.
At the height of winter, Queenstown Airport expects almost 60 transtasman flights a week, a record.
