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Objectives: The purpose of this qualitative study is to describe patient and staff safety incidents and near misses in out-of-hospital emergency care with the aim of providing new knowledge that can be useful in preventing and decreasing risks in emergency care. Research Methodology and setting: The data consisted of voluntary, anonymous reports collected online from emergency care staff in 2013 in one hospital district that serves a population of 200,000 in Finland. A total of 45 incident descriptions of adverse incidents, risks and near misses were accrued, all of which were analyzed using inductive content analysis. Results: The results reveal that threats to patient safety are associated with the patient’s psychological and physical status, medication, care equipment and context. In occupational safety of emergency care providers, the patient’s mental ill-being and aggression, the context, care equipment and emergency driving constitute potential sources of risks. Conclusion: As only a limited number of incidents were reported, staff should be encouraged to use the reporting system as an essential part of quality management in emergency services. More attention needs to be paid to assessing the overall emergency situation from the viewpoint of safety and the level and reliability of information before starting diagnostic procedures and treatment. Education and study of earlier safety incidents can help prevent risks.