This paper describes how the Thai health sector developed nationwide emergency medical services (EMS), despite limited resources and we try to extract lessons applicable to other resource-constrained settings. The government of Thailand has strengthened EMS by integrating it into the general healthcare system and formulating a national development plan and lead agency for EMS. The government emphasized the deployment of low-cost basic-level EMS units stationed near the communities, named as 'first-responder units'. In Khon Kaen Province, which has led the nationwide EMS development of Thailand, the availability of EMS (number of EMS units) and utilisation of EMS (proportion of severe trauma patients transported to hospital by EMS) greatly increased from 2000 to 2017. This success is due to the emphasis on the first-responder units through consistent national policies.
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