Emergency Medical Service system in community and rural areas: A Scoping Review

Emergency Medical Service (EMS) systems are critical for time-sensitive conditions; however, evidence regarding their operation in community and rural areas remains fragmented. This scoping review addresses the gap in synthesized literature (2020–2025) linking specific service delivery processes from notification to transport with reported operational outcomes. The specific objectives are: To map the characteristics of community and rural areas EMS workflows (notification, dispatch, response, transport). To synthesize operational outcomes, encompassing both clinical (survival, safety) and system-level (response times, equity) dimensions. This review follows JBI methodology and PRISMA-ScR guidelines. A comprehensive search will be conducted across electronic databases PubMed, CINAHL, SCOPUS, Medline, ProQuest, ThaiLIS, ThaiJo for English and Thai studies published between 2020 and 2025. Study selection utilizes a PCC Framework. The review will produce a comprehensive operational framework of community and rural areas EMS models and identify evidence gaps. The findings will inform Local Administrative Organizations (LAOs) and policymakers, providing benchmarks to enhance the resilience, efficiency, and equity of prehospital care systems.