Seamless integration of rescue operations ! The Emergency Operations Center of the Fire Bureau of Taichung City Government held a Presentation of Achievements in the Guidance of Physicians and Volunteer Fire Brigades on December 22. In the context of this event, a Memorandum of Understanding (MOU) on online EMS (Emergency Medical Service) direction was concluded with the Taiwan Society of Emergency Medicine, Taiwan Association of EMS Physicians, and Eucare Co., Ltd. This marks a new milestone and groundbreaking accomplishment in the field of pre-hospital emergency care in Taiwan. The Fire Bureau explains that online medical direction refers to physicians authorizing or offering guidance to on-site rescue personnel in the provision of emergency medical services through instant messaging. The process can be illustrated with the case of a stocky man who suddenly experienced life-threatening arrhythmia during a ball game. His heart rate increased to 195 beats/min and he was on the verge of death. Synchronized cardioversion was immediately initiated with the help of an online EMS physician, which who successfully saved his life. In a pioneering move, the Fire Bureau formed the first volunteer first-aid and fire brigade composed of EMS physicians in Taiwan in June of this year with a view to facilitatingto facilitate the provision of regular, high-quality online medical direction. This brigade consists of 19 members from all major hospitals and medical institutions, including China Medical University Hospital, Chung Shan Medical University Hospital, Taichung Veterans General Hospital, Kuang Tien General Hospital, Tungs' Taichung MetroHarbor Hospital, Cheng Ching Hospital Chung Kang Branch, Asia University Hospital, and Everan Hospital. The Bureau further points out that, since its establishment, the brigade has provided online consultation and interpretation of 12-lead ECG (electrocardiogram) in over 1,200 cases and smartphone-based authorization of resuscitation medication and advanced life support administration in 15 cases via the online medical direction LINE group with excellent results. Due to the fact that EMS involves patient privacy, it is imperative to utilize a high-quality, real-time service platform with information security authentication properties. Starting in mid-October, the Bureau therefore launched the Eucare Telehealth Platform for online medical direction on a trial basis. This platform was well received by firefighting personnel and EMS physicians, who expressed deep satisfaction with the immediacy and quality of the platform. Dr. Chen Wei-Kung, Director of the Emergency Department of China Medical University Hospital and leader of the volunteer brigade consultant team, reveals that the Eucare Telehealth Platform cooperated with the Taiwan Society of Emergency Medicine and assisted the Ministry of Health and Welfare in telemedicine consultation services such as epidemic prevention for expatriates, self-isolation, diversion and dispatch, and diagnosis of positive cases during the COVID-19 pandemic. During the most severe wave of the Omicron variant, the telehealth consultation platform, which is currently the most complete of its kind in Taiwan, handled over 13,000 online consultation cases. Fu-You Sun, Director-General of the Fire Bureau, shares that that there are numerous cases of successful emergency treatment through online medical direction such as the performance of synchronized cardioversion and 12-lead ECG for critical myocardial infarction patients and prompt notification of the nearest hospital, administration of transcutaneous pacing for patients with weakening pulse, and administration of epinephrine for anaphylaxis patients. The goal is to provide critical patients with hospital-grade care prior to arrival at the hospital. In recent years, the Bureau has been firmly committed to training Emergency Medical Technician-Paramedics (EMT-P) and provision of advanced pre-hospital careproviding advanced pre-hospital care, including cardioversion, intubation, intravenous and intraosseus injection, and administration of resuscitation medication with the ultimate goal of raising the survival rate for OHCA (out-of-hospital cardiac arrest) patients. In addition, the Bureau relies on orders given by online EMS physicians to ensure optimal first-aid treatment for patients within the golden four to six minutes after cardiac arrest. This is an inevitable trend in the field of EMS development in advanced countries and all cities and counties of Taiwan. Director Sun stresses that “we need more EMS physicians to join our volunteer first-aid and fire brigade!” He warmly welcomes outstanding physicians to become members of the brigade and, thereby upgrade upgrading the manpower and quality of online medical direction in Taichung City and provide providing the Bureau with the ability to better safeguard the health and safety of city residents. Director Sun expresses his deep gratitude to Eucare Co., Ltd. for providing an online platform and technical support free of charge. The ultimate goal is to transform Taichung into a smart, safe city and national benchmark and apply its successful experiences to other cities and counties in Taiwan through collaboration between industry, government, and academia in the field of online medical direction.