A remote monitoring and directing system including at least one video camera at the first-aid side to observe the situation of casualty and the operation on the casualty is provided. At least one microphone is disposed at the first-aid side for communicating with the first-aid personnel and directing a clinical operation. At least one medical instrument standard interface is disposed at the first-aid side for transmitting the electrocardiogram or other physiological information. At least one video/audio and data server is disposed at the monitoring side for managing information integration. A plurality of authorized computer systems is set up for conferring with and directing the first-aid station or the ambulance via the Internet, so as to give a direction. A wireless or cable connection is used for the conference between the first-aid side and the monitoring side.