In Thailand, emergency illnesses are lifethreatening conditions that constitute serious health problems and quick access to definitive care can improve the survival rate of the elderly dramatically. Currently, the pre-hospital emergency medical services have limitations which prevent the treatment from getting to the accident site on time. In this research, we proposed the A-SA SOS application, a mobile-and IoT-based pre-hospital emergency service for the elderly. The system helps the elderly to send the request to the nearest village health volunteers via a mobile application and smart device. After reaching the elderly, the village health volunteers help carry out basic life support to increase the survival rate before sending the patients directly to the Emergency Management System (EMS) agency. To evaluate the system, we tested it for three months in the Sub-district of Suthep in Chiang Mai city. Finally, the incident report showed that the average time to reach the scene (4.91±0.56) to help elderly patients was less than the standard criteria of an average 3 minutes.