Prehospital Emergency Medical Care Research Articles

Utilisation of prehospital intravenous access.

To describe the use of intravenous (IV) therapy in the South African (SA) prehopsital setting, and to determine the proportion of prehopsital cannulations considered unnecessary when graded against the South African Triage Score (SATS) chart. The study was conducted in the prehospital emergency medical care setting in the Western Cape Province, SA. Using a descriptive research design, we looked at the report forms of patients treated and transported by personnel currently employed in the public sector, serving the urban and rural areas stipulated by the municipal boundaries. All medical and trauma cases in which establishment of IV access was documented for the month of April 2013 were included. Interhospital transfers, unsuccessful attempts at IV access and intraosseous cannulation were excluded. When graded against the SATS, prophylactic IV access was not justified in 42.3% of the total number of cases (N=149) in which it was established, and therefore added no direct benefit to the continuum of patient care. It is worth noting that 18.8% (n=39) of the IV lines were utilised for fluid administration, as opposed to 9.2% (n=19) for the administration of IV medications. In view of the paucity of studies indicating a direct benefit of out-of-hospital IV intervention, the practice of precautionary, protocol-driven prophylactic establishment of IV access should be evaluated. Current data suggest that in the absence of scientific evidence, IV access should only be initiated when it will benefit the patient immediately, and precautionary IV access, especially in non-injured patients, should be re-evaluated.

Prehospital System Development in Jaffna, Sri Lanka

The building of prehospital emergency medical care systems in developing and lower middle-income countries (as defined by the World Bank) is a critical step in those countries' efforts to reduce unnecessary morbidity and mortality. This case report presents the development of a prehospital care system in Jaffna District, Sri Lanka and provides the results of the system's first year of operations, the likely reasons for the results, and the prospects for sustained operations of the system. The goal of this report is to add to the literature surrounding Emergency Medical Services (EMS) in developing countries by providing insight into the implementation of a prehospital emergency care system in developing and lower middle-income settings. The level of utilization and the financial performance of the system during its first year of operation were analyzed using data from the Jaffna Regional Director of Health Services (RDHS) Call Center database and information from the implementing organization, Medical Teams International. The system responded to >2000 emergency calls in its first 11 months of operation. The most utilized ambulance of the system experienced only a US $13.50 loss during the first 12 months of operation. Factors such as up-front support, a systematic approach, and appropriateness contributed to the successful implementation of the Jaffna prehospital EMS system. The implementation of a prehospital EMS system and its functioning were successful in terms of utility and, in many regards, financial stability. The system's success in development may serve as a potential model for implementing prehospital emergency medical care in other developing and lower middle-income country settings, keeping in mind factors outside of the system that were integral to its developmental success.

Mental health of nurses involved in prehospital emergency medical care

Mental health of nurses involved in prehospital emergency medical care

Prehospital Emergency Care in Shanghai: Present and Future

BackgroundIn Shanghai, prehospital emergency medical services are provided by the public Ambulance Services. The 60th anniversary of the local Ambulance Services is a good opportunity to provide an overview of the current trends in prehospital emergency medical care in Shanghai. ObjectivesIn this report, the features of Shanghai prehospital emergency medical care are described, as well as the Shanghai model of purely prehospital emergency medical care, including the communications and dispatch system, ambulance depots and ambulances, and prehospital rescue teams. Responses to major incidents including public health emergencies and natural disasters are also discussed, with the intention of highlighting future directions in emergency medical services, as well as the influence of international trends in emergency patient care. DiscussionAlthough Shanghai has the most advanced dispatch system in China (equipped with a Global Positioning System, Global Information System, and more) and can be expanded quickly in case of mass casualty incidents, there is, as yet, no uniform Emergency Medical Service (EMS) dispatching for the entire city. Nor are there certifications, degrees, or special continuing education programs available for EMS dispatchers. Although there are more and more ambulance depots spread all over Shanghai, the city struggles with inadequate prehospital emergency caregivers, because every ambulance has to be staffed with a qualified Emergency Physician, and there are also recruitment problems for ambulance physicians. ConclusionsAlthough faced with many challenges, substantial progress is expected in Shanghai prehospital emergency care.

병원 전 뇌졸중 환자의 구급의료 실태 분석

This study analyzes the influencing factors of prehospital 119 Emergency Medical Service for Stroke Patients in prehospital. From July, 2010 to June, 2011, 123 patients were diagnosed with Stroke in Emergency Medical Center. Among 123 patients, the prehospital assessment rates were as follows : blood pressure checked 73.2 %, pulse checked 73.2 %, respiratory checked 64.2 %, SpO2 checked 79.7 %, pupil reflex test 88.6 %, Electrocardiogram checked 14.6 %, blood sugar checked 19.5 %. Prehospital emergency medical care, Oropharyngeal airway insertion 2.4 %, Manual airway maneuvers 17.1 %, endotracheal intubation 2.7 %, oxygen supply 35.4 %, and suction and intravenous fluid therapy 0 %. The property of mental status evaluation by 119 Emergency Medical Service was nearly perfect, but the patients assessment and emergency medical care were not.

Improvement of the pre-hospital emergency medical service system in China

Purpose : Emergency medical services in China are increase in demand by people and under the greater pressure than ever before. So it is, necessary to advance the pre-hospital system in order to promote the development of emergency medical services. Methods : This is based on China-related articles, books, journals, reports, statistical data and other literature. Results : First, pre-hospital emergency medical care with the introduction of specialist training program should be established. Second, to strengthen pre-hospital emergency services and to develop the EMS guidelines. Third, the 120 reporting systems unification and awareness activation. Fourth, the preparation of the EMS facilities equipment system. Fifth, the rapid transport system establishment to the selected medical institutions. Conclusion : It is necessary to strengthen the emergency medical personnel at the scene, rapid transport, rapid patient triage and to improve the survival rate of the patients.

Iraqi community members' knowledge, attitude and practice of emergency medical care: assessing civilian emergency medicine in an area of conflict

The objective of this article is to assess community member knowledge, attitude, and practice of emergency medical care in Baghdad, Iraq. We performed a randomized, cluster-based, household Knowledge, Attitude, and Practice (KAP) survey regarding pre-hospital and hospital-based emergency medical care among Baghdad community members. A total of 1172 individuals participated in the survey. While most (93.5%) understood that for a serious injury, one should go to the hospital within three hours, only half (50.6%) felt that ambulances were beneficial and only 5% knew that there was a number to call in case of medical emergency. Regarding attitudes, only half (50.2%) of those interviewed felt an ambulance would arrive within an hour, while higher proportions of people believed that paramedics (59.1%) and medical staff working in emergency departments were adequately trained (71.5%). In terms of practice, most Iraqis responded that they would seek care in a hospital (84.8–90.0%) by means other than an ambulance (98.0–99.2%). However, if an ambulance arrived, 77% would allow it to transport their friends/family and 73.5% would trust the medical staff in the hospital to appropriately treat them. Our conclusion is that emergency medical care in Iraq is still in the development phase. Although numerous ambulances have been commissioned, scores of paramedics have been trained, and staff working in Baghdad Emergency Departments have undergone updates in their practice, the public does not appear to be fully informed of these changes. Future developments in Iraqi emergency medical care should include targeted efforts to expand the public awareness of such services.

Besonderheiten der notärztlichen Versorgung von Kopf-/Halsverletzten

The overall incidence of severe head, face and neck injuries as seen from the German Trauma Registry of the National Association of German Trauma Surgeons is 81.3%. The leading causes of death among these patients are hemorrhage and severe traumatic brain injury. The aim of prehospital emergency medical care is to stabilize vital functions in order to ensure primary survival and to reduce morbidity with appropriate prehospital treatment of the individual injuries within the overall injury pattern. In this review, special aspects as well as pitfalls of the prehospital management of patients with head, face and neck injuries are demonstrated. Prehospital airway management concepts as well as concepts for stopping bleeding in the head, face and neck region are discussed in detail.

The Dublin cardiac arrest registry: temporal improvement in survival from out-of-hospital cardiac arrest reflects improved pre-hospital emergency care

Out-of-hospital cardiac arrest (OOHCA) survival remains poor, estimated at 3-7%. We aim to describe the incidence of OOHCA, survival from OOHCA, and the impact of improved pre-hospital care on survival from OOHCA. A retrospective registry was established using multi-source information to assess survival from cardiac arrest following the introduction of several improvements in pre-hospital emergency medical care from 2003. Survival from OOHCA, from asystole/pulseless electrical activity, and from ventricular tachycardia/ventricular fibrillation was estimated. Adjusted per 100 000 population annual incidence rates from national population census data were calculated. Mean and median emergency medical services (EMS) response times to OOHCA calls were assessed. A total of 962 OOHCAs occurred from 1 January 2003 until 31 December 2008. Sixty-nine per cent (69%, n = 664) were male. Seventy-two per cent (72%, n = 693) occurred at home with 28% occurring in a public venue. Of these public venues, 33.9% (91 of 268) had an automated external defibrillator available. Bystander cardiopulmonary resuscitation (CPR) was in progress when emergency services arrived in 11% (n = 106) of the cases. Nineteen per cent (19.4%, n = 187) had a known prior cardiac history or chest pain prior to circulatory collapse. Overall survival to hospital discharge improved significantly from 2.6 to 11.3%, P = 0.001. Survival from ventricular fibrillation (VF) to hospital admission, rose from 28.6 to 86.3%, P = 0.001. Survival to hospital discharge from VF improved from 21.4 to 33%, P = 0.007. Mean EMS response times to the scene of arrest decreased from 9.18 to 8.34 min. Emergency medical services scene time, reflecting acute pre-hospital medical care, rose from 14.46 to 18.12 min. The adjusted incidence of OOHCA for our catchment population declined from 109.4 to 88.2 per 100,000 population between 2003 and 2008. The incidence of OOHCA has declined but importantly, survival to hospital discharge has improved dramatically. Reduction in ambulance response time, resulting in earlier initiation of basic and advanced life support and earlier defibrillation, was associated with an increase in the proportion of victims found in VF rather than asystole and likely accounted for most of the improvement. Further improvements in response times and public education to improve bystander CPR rates should remain a priority.

Alcohol-Associated Illness and Injury and Ambulance Calls in a Midwestern College Town: A Four-Year Retrospective Analysis

Background. Alcohol is often a factor in illness and injury among college-aged individuals. Ambulance services responding to 9-1-1 calls in college towns regularly encounter patients who have consumed alcohol to the point of intoxication and subsequently suffered an injury or experienced an illness necessitating prehospital emergency care. Objectives. The first objective was to review ambulance calls in a Midwestern college town in order to identify patterns or trends related to alcohol consumption. Another objective was to determine to what extent, if any, underage drinking was a factor in these calls. A final objective was to determine whether there were types of illness or injuries related to 9-1-1 calls that were involved with alcohol consumption among college-aged students. Methods. This was a retrospective study using secondary data of four years of ambulance calls that occurred in a specific geographic region of a college town. All patient care reports (PCRs) included alcohol consumption as a pertinent factor in the call. Data were de-identified and in some cases aggregated to ensure confidentiality. Descriptive statistics were used to identify prevalence and incidence of injury and illness and patient demographics. Results. Of the ambulance calls for service in the geographic area, 44.4% to 45.8% identified as “downtown” had alcohol consumption as a reported factor in the PCR. The number of calls for service that involved patients below the legal drinking age (21 years) was small but increased between 2004 and 2007. Calls involving male patients made up the majority of calls with alcohol as a factor. The majority of alcohol-related calls for service were for traumatic injuries, sexual assaults and rapes, poisonings or drug ingestions, and altered levels of consciousness. Conclusion. Alcohol consumption was a comorbid factor in illness and injury that necessitated prehospital emergency medical care in one Midwestern college town. Further research is needed to determine whether these results can be generalized beyond this one geographic location or if causality can be determined between alcohol consumption and injuries or illnesses that lead to emergency medical services calls.

Attitudes to Living and Working in Pandemic Conditions among Emergency Prehospital Medical Care Personnel

Little is known about the risk perceptions and attitudes of healthcare personnel, especially of emergency prehospital medical care personnel, regarding the possibility of an outbreak or epidemic event. This study was designed to investigate pre-event knowledge and attitudes of a national sample of the emergency prehospital medical care providers in relation to a potential human influenza pandemic, and to determine predictors of these attitudes. Surveys were distributed to a random, cross-sectional sample of 20% of the Australian emergency prehospital medical care workforce (n = 2,929), stratified by the nine services operating in Australia, as well as by gender and location. The surveys included: (1) demographic information; (2) knowledge of influenza; and (3) attitudes and perceptions related to working during influenza pandemic conditions. Multiple logistic regression models were constructed to identify predictors of pandemic-related risk perceptions. Among the 725 Australian emergency prehospital medical care personnel who responded, 89% were very anxious about working during pandemic conditions, and 85% perceived a high personal risk associated with working in such conditions. In general, respondents demonstrated poor knowledge in relation to avian influenza, influenza generally, and infection transmission methods. Less than 5% of respondents perceived that they had adequate education/training about avian influenza. Logistic regression analyses indicate that, in managing the attitudes and risk perceptions of emergency prehospital medical care staff, particular attention should be directed toward the paid, male workforce (as opposed to volunteers), and on personnel whose relationship partners do not work in the health industry. These results highlight the potentially crucial role of education and training in pandemic preparedness. Organizations that provide emergency prehospital medical care must address this apparent lack of knowledge regarding infection transmission, and procedures for protection and decontamination. Careful management of the perceptions of emergency prehospital medical care personnel during a pandemic is likely to be critical in achieving an effective response to a widespread outbreak of infectious disease.

Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic

Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services. This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behavioral responses of Australian emergency prehospital medical care providers in pandemic conditions. Using a reply-paid postal questionnaire, the knowledge and attitudes of a national, stratified, random sample of the Australian emergency prehospital medical care workforce in relation to pandemic influenza were investigated. In addition to knowledge and attitudes, there were five measures of anticipated behavior during pandemic conditions: (1) preparedness to wear personal protective equipment (PPE); (2) preparedness to change role; (3) willingness to work; and likely refusal to work with colleagues who were exposed to (4) known and (5) suspected influenza. Multiple logistic regression models were constructed to determine the independent predictors of each of the anticipated behaviors, while controlling for other relevant variables. Almost half (43%) of the 725 emergency prehospital medical care personnel who responded to the survey indicated that they would be unwilling to work during pandemic conditions; one-quarter indicated that they would not be prepared to work in PPE; and one-third would refuse to work with a colleague exposed to a known case of pandemic human influenza. Willingness to work during a pandemic (OR = 1.41; 95% CI = 1.0-1.9), and willingness to change roles (OR = 1.44; 95% CI = 1.04-2.0) significantly increased with adequate knowledge about infectious agents generally. Generally, refusal to work with exposed (OR = 0.48; 95% CI = 0.3-0.7) or potentially exposed (OR = 0.43; 95% CI = 0.3-0.6) colleagues significantly decreased with adequate knowledge about infectious agents. Confidence in the employer's capacity to respond appropriately to a pandemic significantly increased employee willingness to work (OR = 2.83; 95% CI = 1.9-4.1); willingness to change roles during a pandemic (OR = 1.52; 95% CI = 1.1-2.1); preparedness to wear PPE (OR = 1.68; 95% CI = 1.1-2.5); and significantly decreased the likelihood of refusing to work with colleagues exposed to (suspected) influenza (OR = 0.59; 95% CI = 0.4-0.9). These findings indicate that education and training alone will not adequately prepare the emergency prehospital medical workforce for a pandemic. It is crucial to address the concerns of ambulance personnel and the perceived concerns of their relationship with partners in order to maintain an effective prehospital emergency medical care service during pandemic conditions.

Editorial Comments–Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic

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Prehospital Emergency Care in Hungary: What Can We Learn from the Past?

In Hungary, prehospital emergency medical services are provided by the National Ambulance Service. The 60(th) anniversary of the National Ambulance Service provides a good opportunity to give an overview of the current trends in prehospital emergency medical care in Hungary. In this report, a description of the organizational structure and the latest developments in the National Ambulance Service are described with the intention to highlight future directions in emergency medical services, as well as the influence of international trends in emergency patient care. In Hungary, the ambulance cars are staffed by two or three crew members trained in rescue, stabilization of the patient's status, transport, and advanced care of traumatic and medical emergencies. There are three major levels of care provided by ambulance personnel: a basic level ambulance crew (Emergency Medical Technician Unit), a second level (Ambulance Officer Unit), and the highest level (Emergency Physician Unit). The personnel on the latter two units are trained in all aspects of Basic Life Support and Advanced Life Support procedures for prehospital emergency care. Following the latest international developments in medical rescue devices and guidelines, all staff are retrained yearly. Recently, private services for transportation for non-acute illnesses have been introduced, allowing the National Ambulance Service to concentrate on emergencies only. Although the Hungarian Ambulance Service has a very long and meaningful past and a respected professional development, new challenges facing prehospital emergency care are inevitable and continuous development is necessary.

Real-time medical control using a wireless audio-video transmission device in a pre-hospital emergency service in Korea

We developed a hands-free portable device which can provide two-way, real-time audio and video communication between hospital doctors and emergency medical technicians (EMTs) providing pre-hospital care. The device was based on an ultra mobile PC with a camera, a microphone/earphone set and a WIBRO modem for wireless Internet connection at an average data transmission rate of 1 Mbit/s. Feasibility tests were conducted in 55 real emergency situations over a period of three months at five different Rescue Centres in Seoul. Successful communication between an EMT and a doctor was achieved in 46 cases (84%). The device showed acceptable performance in terms of audio/video transmission time delays and maximum transmitted video frame rates, both outdoors, inside a building and in a moving vehicle at 70 km/h. Eight control centre staff and 11 EMTs who used the device completed a questionnaire. Despite acceptable basic performance, the device was found to be limited in terms of the contribution it made to the medical control of EMTs. However, improvements in device performance should produce higher quality pre-hospital emergency medical care in the future.

Alteplase for Acute Ischemic Stroke. Experience in an Emergency Department of a Community Hospital

Background: Intravenous administration of recombinant tissue plasminogen activator (rt-PA) remains the most beneficial proven intervention for emergency treatment of stroke. Objective: To assess the implementation of the “Stroke code” in routine clinical care at our Emergency Department (ED) from November 2005 to March 2009 and to describe the clinical outcome of patients who received treatment with intravenous rt-PA. Methods: The aim of the “Stroke code” is the early recognition of selected patients with a suspected stroke who may be treated with thrombolysis therapy, implemented in our hospital in November 2005. Prehospital emergency medical services, ED, Critical Care, Radiology, and Neurology departments are implicated. Inclusion criteria for intravenous administration of rt-PA (0.9 mg/Kg) were: age 18 years or greater, measurable neurological deficit, NIHSS (National Institutes of Health Stroke Scale) > 4 and < 25, onset of symptoms < 3 h before beginning treatment, computed tomography (CT) scan without a multilobar infarction (hypodensity > 1/3 cerebral hemisphere). Results: There were 120 “Stroke codes” activated from November 2005 to March 2009. rt-PA was administered in 52 patients (43.3%), 33 patients were males and 19 females. Mean age was 63.6 years. APACHE II (Acute Physiology and Chronic Health Evaluation II) (admission) = 9.1 ± 3.2 points. Intensive care unit length of stay was 3.8 ± 1.6 days; 78.8% of patients had vascular risk factor; 26.9% were with aspirin at stroke onset. Post-treatment study imaging was performed 48 h after thrombolysis: 6 patients developed in CT hemorrhagic infarct type 1 (asymptomatic small petechiae along the margins of the infarct). Two patients died due to cerebral infarction with cerebral edema. Median NIHSS scores were 13.4 points at admission and 9.8, 8.3, and 7 at 2, 24, and 48 h after treatment, respectively. Conclusions: The ED plays an important role in the early recognition of selected patients with a suspected stroke for administration of rt-PA. rt-PA improved clinical outcomes and is safe in patients with acute ischemic stroke.

The Future of Emergency Medical Service System Based on Prehospital Emergency Medical Care

Prehospital emergency medical care (PEMC) refers to events in which a medical crew, including emergency physicians and nurses, is dispatched to a prehospital scene to provide treatment for patients. The Japanese HEMS (Helicopter Emergency Medical Service) system, also known Doctor-Helicopter, has enabled the establishment of a PEMC system. The Hokusoh HEMS has been dispatched on 587 missions, representing 15.6% of all Japanese HEMS dispatches to emergency sites in 2008. Among 151 trauma patients with an Injury Severity Score greater than 15, the Revised Trauma Score at the time of arrival at the emergency department was significantly higher than that before the prehospital treatment provided by HEMS (6.57±1.63 vs. 6.16±1.65; p<0.001). The coronary angiography time was also significantly shorter in the HEMS group than in the ground ambulance group (98.8±29.2 minutes vs. 126.6±48.7 minutes; p<0.05). These results show that the Japanese HEMS system can help improve the emergency medical system, as have similar helicopter services in the United States and Europe. However, a rapid response ground-based system is also needed to compensate for limitations of the HEMS, such those arising from weather and night-time conditions. Furthermore, the PEMC system requires an early alert and over-triage of the helicopter or ground ambulance dispatch (THESE TERMS ARE STILL UNCLEAR). The HEMS should also be available to transport Disaster Medical Assistance Teams to disaster sites, such as major accidents or earthquakes. Thus, the efficient deployment and networking of the HEMS are needed for the practical use of Doctor Helicopters in disaster situations. The education and training of young physicians dispatched to the scenes of accidents is also essential for establishing the PEMC system. Such physicians must not only be able to treat patients but must also have the discretion and talent to control the accident site and assume a leadership position. Such skills should be fostered through on-the-job training involving actual missions onboard a helicopter or a ground ambulance while accompanied by a senior physician, rather than through lectures or simulations. The PEMC represents proactive, not reactive, medical care and may offer a solution to the present insufficiencies in emergency health care. The Hokusoh HEMS wishes to propose a new model for emergency medical services through the use of a PEMC system incorporating both helicopter and ground-based ambulances.

Cardiogenic Shock – Developments and Treatment Strategies

Cardiogenic shock remains one of the most serious and challenging conditions in cardiology and is responsible for the highest in-hospital mortality associated with ST-elevation myocardial infarction. The only significant treatment strategy that has been shown to reduce its incidence and inherent mortality is emergent coronary revascularisation. Prevention should aim at early recognition of symptoms, appropriate pre-hospital emergency medical care and prompt primary revascularisation. Once established, cardiogenic shock still has an unacceptably high mortality rate. Approaches that include new pharmacological therapies and other forms of mechanical haemodynamic support are under investigation. The possible role of systemic inflammatory response has led to the investigation of nitric oxide synthase inhibition, although initial results with tilarginine were disappointing. The use of percutaneous left ventricular assist devices looks promising, but hard data regarding mortality benefit are still missing. Cardiogenic shock remains a perplexing and often fatal condition. The future may require more basic, translational and clinical research.

Is There One Optimal Medical Treatment and Evacuation Chain for All Situations: “Scoop-and-Run” or “Stay-and-Play”

In 2006, the Ministry of Defense of the Netherlands initiated a targeted agenda program for the World Congress on Disaster and Emergency Medicine in Amsterdam in 2007 (15WCDEM). The issue to be discussed was if there is one "golden" treatment and evacuation system that is applicable for different military and civilian situations. And, if there is not such a system, which parameters are important to construct the most optimal system for each different situation. This issue is related to the applicability and evidence base of the standards of the North Atlantic Treaty Organization. A group of experts started a website discussion on the issue during December 2006. During the 15WCDEM, several other participants were active in the discussion. Using the different experiences and the outcome of the discussions, it was concluded that there is not one "golden" medical emergency system, there are no "golden" timelines, and no "golden" skills. A medical system should be flexible and be able to adjust on each specific, local situation. First responder and non-medical people with medical skills (first responders) are essential in the front line of the emergency medical systems. More research is needed on the medical techniques and skills that are most effective early in the treatment and evacuation systems. Lessons learned from the military system are relevant for the civilian emergency medical services and vice-versa. The World Association for Disaster and Emergency Medicine can be an important platform to share and exchange information between these two systems. The target of the platform should be to obtain a generic picture of the important elements in prehospital emergency medical care.

The epidemiology of pre-hospital emergency medical care in Nanxing District of Shanghai

Objective The pre-hospital data of 839 emergency patients who were admitted to Naxiang Emergency Center of Shanghai from Dec 11 2006 to Jun 11 2007 were analyzed.The first five causes of emergency call were trauma,diseases of newborns,neuron-system diseases.eardio-vascuIar diseases and digestive diseases.The epidemiological data including gender,age of patients,distance to emergency site,duration of ambulance dispatch,results of first aid.etc were also presented in the paper.These data would be helpful for improving pre-hospital medical care of emergency patients. Key words: Emergency medical services; Epidemiology