Background The pre-hospital care providers in Thailand are always challenged by the task difficulty in working with limited resources and spaces, as well as the high risk of encountering traffic accidents. This study aims to elaborate situation and analyse the causes and factors of the ambulance crash in Thailand.

Methods This was a retrospective analysis of all fatal ambulance crash on Thailand public roadways in 2014, from the secondary data in three main sources, including the database of Information Technology for Emergency Medical System (ITEMS), the records of surveillance ambulance accident of EMS from January to December 2014, and the report of ambulance accident investigation collected from the local network in 2014, using the Haddon’s matrix approach. The study was conducted from January to March 2015. The results are presented using descriptive statistics

Results According to the ambulance accident surveillance data, 61 ambulance accidents occurred in 2014, resulting in 130 injured victims and 19 deaths. The number of accidents is more concentrated during June to August (25 times). The accident rate is 0.05 with the mortality rate of 0.02 per 1,000 operations. Factors related to accident and safeness of the ambulance could be concluded into human factors, vehicle and equipment factors, and road environment factors. Human factors include lack of ambulance driving training, unfastened seat belts, and high speed driving exceeding 90 km/hr. Unregistered ambulance and missing GPS installation contribute to the lack of vehicle standard. The disparity in each local road environment such as speed curve, crowded site, and missing directive signs lead to higher risk of accident.

Conclusions The proportion between the numbers of ambulances to the Thai population had been declining over the past years. However, accidents caused from the above three factors were still prevalent. Therefore, it is necessary for the related organisations to implement new policies and take actions towards preventing future ambulance accidents.