Background In Pakistan, Emergency Medical Services (EMS) is in its infancy and only recently has pre-hospital care begun to take shape. There is strong evidence that EMS systems that are both economical and provide fundamental care can improve the overall effectiveness of pre-hospital care.

Methods This cross sectional study was conducted among physicians, final year medical students, nurses, ambulance drivers and the general public. Physicians, students and nurses of various seniority levels were selected from two teaching hospitals in Karachi, Pakistan. A convenience sample of ambulance drivers and general public was selected.

Results 357 people were interviewed for this study (physicians/students n=192, nurses=41, ambulance drivers=24, general population=100). On a scale of 1–10 all strata scored EMS to be an important part of emergency care (combined mean score 8.21±2.1). All groups supported charges of less than 500 rupees (6 US dollars) for a one time use of an ambulance service (physicians/students=72%, nurses=98%, ambulance drivers=88%, general population=80%). A large portion of each strata agreed that faster ambulances would save more lives (physicians/students=57%, nurses=67%, ambulance drivers=65%, general population=68%). Each group also approved that better equipped ambulances would save more lives (physicians/students=64%, nurses=57%, ambulance drivers=57%, general population=80%).

Conclusion EMS is perceived as an important health intervention by providers and users. Effective EMS systems should be integrated into pre-hospital care in Pakistan.