This paper studies the application of blockchain technology in smart emergency scenarios, with a focus on improving the PBFT algorithm. The development of smart first aid systems aims to improve the speed ofemergency response and resource coordination efficiency. Therefore, this study introduces blockchain into the field of smart first aid to address the challenges of information security and credibility. By storing critical patient information on the blockchain, the system can provide faster and more accurate medical services. In terms of improving the PBFT algorithm, this study focuses on improving performance, scalability, and security. Propose an improved WR-PBFT algorithm, mainly focusing on multi node consensus and reducing communication complexity. The improved WR-PBFT algorithm exhibits better real-time performance and efficiency in intelligent emergency scenarios. The improvement in scalability and security makes it suitable for large-scale emergency applications and can withstand potential attacks and failures. Overall, the research results of this paper provide theoretical support for building a safer and more efficient intelligent emergency system. Future work should focus on optimizing specific applications, continuing to improve consensus algorithms, and adapting to growing demands.