Background: Effective Emergency Medical Services (EMS) aim to provide timely care for medical emergencies, including pre-hospital care, transfer, and in-hospital treatment. A well-coordinated, designed, and locally appropriate system is crucial for rapid assessment, timely intervention, and prompt transportation to appropriate facilities. However, emergency care services often receive low priority in low-income countries.Rapid Response Question: Are hospital-based Emergency Medical Services effective and efficient?Findings: Hospital-based EMS are a leading option in Uganda due to existing infrastructure, personnel, and equipment. However, they face challenges such as demand outpacing capacity, emergency department crowding, boarding, ambulance diversion, inefficient resource use, inadequate surge capacity, medical liability, fragmented systems, lack of performance measurement and accountability, and inadequate research and infrastructure.Conclusion: Strengthening emergency and trauma systems in Uganda could improve survival rates. While hospital-based services are currently favored, their effectiveness is compromised by several factors that reduce quality and efficiency. Efforts to improve this situation include using observation wards and increasing the involvement of primary or lower-level facilities in emergency care. More research on emergency and trauma care in low-income countries is needed.
