The Kingdom of Bhutan is a small, mountainous country with limited financial resources. Its population is scattered in hard-to-reach villages with poor road access. Ambulance drivers piloting Toyota Landcruisers provide the majority of the country’s emergency response and are dispatched by the national emergency response center (Health Help Service/112) to calls in the nation’s twenty districts.

By collecting and analyzing prehospital response data, we aimed to describe Bhutanese emergency medical response (EMS) ambulance activities and make system-wide recommendations to improve the speed of emergency vehicle dispatch, reduce the time between ambulance activation and ambulance arrival on scene, and adequately describe emergency vehicle drive time as it relates to distance driven.

The following data was compiled in Excel: Dispatch center phone records, EMS ambulance activation times, drive times, vehicle geospatial data, and written records of ambulance drivers. No identifiable data was collected.

Inclusion Criteria: All prehospital calls from 2017 and 2018 where complete data was available.

Exclusion Criteria: Complete data unavailable, i.e. geographic data without a matching call or report.

Statistical Tools: SPSS Statistics Version 25, NVivo 12-12.2.0.3262.

Preliminary analysis of the data shows a significant difference between data collected and data previously reported, the speed of emergency vehicular response and dispatch, drive times, and distance traveled. Facility transfer rather than scene response was found to take more time.

Due to adverse road conditions, lengthy drive times, and an inadequate number of personnel and satellite ambulance locations, we recommend optimizing ambulance location using an optimization model that will minimize the number of ambulances needed and maximize response time. Future considerations may include adding a ground arm to the Bhutan Emergency Aeromedical Retrieval team, or a second aeromedical team in the eastern part of the country.