The number of critically ill children visiting the emergency department has increased. However, the rate of transporting critically ill children via 119 emergency medical service providers ranges from 4.5% to 17.5%, and the prehospital care is insufficient. To improve the transport, first, it is necessary to expand the prehospital care equipment for critically ill children. Second, 119 personnel should be trained regularly with a revised protocol for the prehospital care. Third, the appropriateness of the prehospital care should be evaluated.