For patients with major trauma or out-of-hospital cardiac arrest (OHCA), every minute can determine survival. To shorten the gap before advanced medical care becomes available, the Department of Emergency Medicine at Far Eastern Memorial Hospital (FEMH) launched its Doctor Car physician rapid-response system. Guided by the principle of bringing emergency medicine to the patient, emergency physicians travel to the scene with advanced medications, equipment, and blood products, working alongside New Taipei City Fire Department emergency medical services teams to deliver treatment before hospital arrival.

Closing the Gap in Advanced Prehospital Care

Although emergency and critical care in Taiwan has advanced rapidly, some treatments can still be provided only after a patient reaches the hospital. Drawing on physician-response vehicle systems used in Europe, Australia, and Japan, FEMH is moving medical capability forward by enabling emergency physicians to assess and treat critically ill or injured patients directly at the scene. Doctor Car does not replace emergency medical technicians (EMTs); it strengthens the existing emergency medical services system by combining rapid fire-department response with hospital-level expertise.

Prehospital care is primarily delivered by EMTs, but procedures such as transesophageal echocardiography (TEE), difficult-airway management, blood transfusion, emergency surgery, and extracorporeal membrane oxygenation (ECMO) activation require physician involvement. During OHCA resuscitation, TEE can provide real-time cardiac images without interrupting chest compressions, helping the team identify reversible causes, assess compression position, and adjust the resuscitation strategy. For patients with hypovolemic shock, blood products are prepared according to blood-bank protocols and transported in temperature-controlled mobile refrigerators at 1-6°C, allowing transfusion to begin as early and safely as possible.

Strengthening Equipment, Medications, and On-Scene Capability

To respond to OHCA, major trauma, and special disasters, the team organizes its equipment into task-based modules, including advanced-airway devices, ultrasound equipment, transfusion supplies, and a dedicated out-of-hospital surgical instrument kit. During major traffic collisions, prolonged entrapment, or unusual rescue operations, physicians can quickly access the equipment needed in austere environments and perform invasive lifesaving procedures when necessary. Doctor Car physicians may also carry anesthetic, analgesic, and sedative medications that EMTs cannot routinely administer, supporting difficult-airway management, severe-pain control, and complex extrication. These capabilities are supported by standard operating procedures, controlled-drug management, repeated simulation, and close communication across teams to protect both speed and safety.

Three Dispatch Pathways Bring Advanced Care to the Scene Sooner

Beginning July 1, 2026, Doctor Car will operate from 11:00 a.m. to 7:00 p.m., Monday through Friday, under three dispatch pathways developed with the New Taipei City Fire Department. First, for suspected OHCA cases in nearby areas such as Banqiao and Tucheng, an ambulance and Doctor Car may be dispatched simultaneously, enabling physicians to provide advanced medications, airway management, and TEE assessment at the scene. Second, for major trauma, mass-casualty incidents, or difficult extrications, the team may respond with blood products and analgesic medications. In prolonged severe entrapment cases, coverage can expand across New Taipei City, with physicians supporting invasive procedures, field triage, and disaster medical command when required. Third, a three-way communication link connects the fire department dispatch center, the on-scene paramedic, and the duty physician. Even before Doctor Car arrives, the teams can jointly assess the patient's condition, determine whether physician deployment is needed, and make immediate medical decisions.

First OHCA Survivor Discharged After Full Recovery

On the evening of March 25, 2026, a 56-year-old man suddenly collapsed in Banqiao. New Taipei City Fire Department personnel immediately began resuscitation and pre-activated the ECMO pathway. The patient briefly regained spontaneous circulation, but anatomical difficulty and strong airway reflexes made intubation challenging, while his blood pressure remained unstable. After Doctor Car arrived, emergency physician Dr. Sheng-En Chu administered vasopressor medication and a neuromuscular blocking agent, successfully secured the airway with an endotracheal tube, and stabilized the patient's circulation.

While treatment continued at the scene, the team alerted the FEMH emergency department and cardiovascular center so that examinations, equipment, and specialists could be ready before the patient's arrival. He was rapidly placed on ECMO and underwent cardiac catheterization with coronary stent placement. Through coordinated care by the emergency department, cardiovascular center, intensive care team, and nursing staff, he made a full recovery and was discharged on April 10, 2026. This case demonstrates the value of a seamless chain linking fire-department EMS, Doctor Car, and in-hospital specialty teams. By extending advanced medical care from the emergency department to the street, time that might otherwise be lost during transport can be converted into an opportunity for survival and recovery.

Building a Sustainable Prehospital Care System