Objective To probe into case simulation contest training to improve emergency the nurse′s first aid skills and comprehensive abilities in Emergency Department ( ED) . Methods A total of 40 emergency nurses, who rotated ED in our hospital from January 2013 to December 2013, were selected as observation group, on the basis of the conventional training added simulation contest training. A total of 38 rotated emergency nurses in our hospital were chosen in January 2012 to December 2012 as control group, and received the implementation of regular training. After training, we compared two groups of nurse training overall appraisal result, simulation technology skills and comprehensive abilities. Results The scores of knowledge theory, skills operation and comprehensive ability evaluation results for rotated ED nurses in the control group respectively were (85. 36 ± 8. 32),(81. 61 ± 8. 22) and (82. 25 ± 8. 01), while the theory of knowledge, skills operation and comprehensive ability evaluation results were (96. 21 ± 8. 21),(93. 54 ± 7. 38) and (95. 04 ± 7. 55) in the observation group, and the scores of observation group were significantly higher than that of the control group, and the differences were statistically significant (t =5. 982,6. 541,7. 015, respectiuely;P <0. 01). The operation skill score in the observation group were higher than that of control group, the differences were statistically significant (P<0. 05). In the observation group, the scores of nurse′s comprehensive ability, such as nursing basic operation, emergency handling capacity, simulated condition judgment, effective cooperation with doctors, nursing records completed and coordination command ability, were higher than these of control group, the differences were statistically significant (P<0. 01). Conclusions Case simulation contest training to learn first aid skills is greatly integrated with clinical application, improves the nurses′ interest in learning, cultivates the coordinated ability, and it promotes nurse′s first aid skills and comprehensive ability, and provides an effective way to train ED nurses.