We developed a hands-free portable device which can provide two-way, real-time audio and video communication between hospital doctors and emergency medical technicians (EMTs) providing pre-hospital care. The device was based on an ultra mobile PC with a camera, a microphone/earphone set and a WIBRO modem for wireless Internet connection at an average data transmission rate of 1 Mbit/s. Feasibility tests were conducted in 55 real emergency situations over a period of three months at five different Rescue Centres in Seoul. Successful communication between an EMT and a doctor was achieved in 46 cases (84%). The device showed acceptable performance in terms of audio/video transmission time delays and maximum transmitted video frame rates, both outdoors, inside a building and in a moving vehicle at 70 km/h. Eight control centre staff and 11 EMTs who used the device completed a questionnaire. Despite acceptable basic performance, the device was found to be limited in terms of the contribution it made to the medical control of EMTs. However, improvements in device performance should produce higher quality pre-hospital emergency medical care in the future.