Public awareness about the emergency conditions and services provided by emergency medical services in the Northern Border Region of Saudi Arabia

Emergency Medical Services (EMS) are critical for prehospital care, yet their effectiveness can be undermined by inappropriate utilization and limited public recognition of true emergencies. This study assessed public knowledge of emergencies and EMS services in the Northern Border Region of Saudi Arabia. A cross‑sectional online survey was conducted between May and December 2025 among adults aged 18–50 years residing in the Northern Border Region. A culturally adapted, previously validated 40‑item questionnaire was disseminated via social media to collect socio‑demographic data, assess EMS knowledge and practices, and evaluate responses to 24 hypothetical emergency and non‑emergency scenarios. Descriptive statistics, chi‑square/Fisher’s exact tests, and multiple logistic regression were used to examine factors associated with correct scenario‑based responses. A total of 1074 participants completed the survey; most were female (58.1%), Saudi nationals (92.5%), and aged 36–46 years (37.0%). Nearly all respondents (99.1%) reported they would call EMS for an unconscious person, and 99.0% correctly identified the EMS number (997). 99.6% knew that EMS both transports and treats patients, and 98.3% understood the dispatcher’s role in receiving calls and providing advice. Scenario performance was less consistent. While 92.3% correctly recognized an elderly patient with acute speech difficulty as an emergency, only 36.2% identified a 35‑year‑old woman with chest heaviness as an emergency. Conversely, 56.9% correctly classified a 30‑year‑old woman with lower abdominal pain and urinary symptoms as a non‑emergency, and only 0.09% recognized that a 4‑year‑old with a foreign body in the ear did not require EMS activation. Older age (≥46 years), female sex, lower education, retirement, Saudi nationality, residence in Arar, and no prior EMS call were independently associated with fewer correct responses (all p < 0.001). In the Northern Border Region, basic EMS knowledge is high, but substantial gaps remain in recognizing specific emergency and non‑emergency conditions. Targeted public education focusing on symptom‑based emergencies and appropriate EMS utilization is needed to optimize EMS effectiveness and resource use.