Objective: To explore the application effect of the emergency center’s standardized pre-hospital first aid program with dispatch guidance (clinical path) as the core in patients with upper gastrointestinal bleeding, and to clarify the impact of dispatch guidance on the quality of first aid. Methods: 46 patients with upper gastrointestinal bleeding who were jointly treated by our center and hospital from January 2020 to December 2021 were selected and divided into a clinical pathway group where our center’s online dispatching telephone dispatch guidance system was implemented in 2021 and a non-implementation clinical pathway group where the center’s dispatch guidance system was not online in 2020 using the random number table method, with 23 cases in each group. The non-scheduling-guided clinical pathway group uses conventional pre-hospital first aid: initial on-site assessment, establishing a single intravenous line for infusion of normal saline, assisting in lateral decubitus positioning to prevent suffocation when vomiting blood, and monitoring consciousness and vital signs during transport, without scheduling guidance throughout the process; the dispatch-guided clinical pathway group uses scheduling guidance Guided standardized first aid: After the dispatcher receives the call, the dispatcher collects the patient’s condition over the phone and instructs the family members on basic first aid. After arriving at the scene, the emergency personnel quickly review the condition according to the dispatch information, implement oxygen inhalation, stop bleeding, establish double venous access and collect blood, and regularly monitor vital signs during transfer and link the hospital for treatment. Compare the emergency-related time indicators, vital sign stability rate and complication rate between the two groups. Results: The emergency-related time indicators in the group with dispatch guidance were shorter than those in the group without dispatch guidance, the vital signs were more stable, and the incidence of complications was lower (P < 0.05). Conclusion: The emergency center adopts a standardized pre-hospital emergency plan with scheduling guidance (clinical path), which can effectively shorten the emergency time for patients with upper gastrointestinal bleeding, improve the stability of vital signs, and reduce the risk of complications. Its core advantage is to optimize the emergency process through pre-scheduling intervention, which has important clinical application value.