What counts as a medical emergency? (UK 999 list)

A medical emergency is something that could cause death, lasting harm or permanent disability if not treated within minutes to hours. In those situations the right call is 999, and the right place is the nearest A&E.

NHS England’s definition of a 999 emergency is short and clear. Dial 999 (or 112) for any of the following, in adults or children:

• Signs of a heart attack — chest pain or pressure, especially with arm or jaw pain.
• Signs of a stroke — face dropping, arm weakness, slurred speech (FAST).
• Severe difficulty breathing — gasping, choking, can’t speak in full sentences.
• Severe bleeding that you cannot stop.
• Severe injuries — after a serious crash, fall, fire, attack or stabbing.
• Loss of consciousness or someone you can’t wake up.
• A seizure (fit) that is the first one or lasts more than 5 minutes.
• Sudden severe headache (worst of your life) or sudden confusion.
• Suspected meningitis — stiff neck, rash that doesn’t fade under glass, photophobia.
• Severe burns or scalds.
• Anaphylaxis (severe allergic reaction with swelling and breathing trouble).
• Choking that’s not cleared with back-blows.
• Drowning, electric shock, severe hypothermia.
• Active suicide attempt or overdose.
• Acute psychosis where someone is a risk to themselves or others.

Stroke is the third most common cause of death in the UK and the leading cause of adult disability. Every minute counts: from onset, more than 1.9 million brain cells die per minute. The classic British public-health mnemonic is FAST:

• F — Face. Has their face fallen on one side? Can they smile?
• A — Arms. Can they raise both arms and keep them there?
• S — Speech. Is their speech slurred or muddled?
• T — Time. Time to call 999.

Symptoms of a heart attack vary, especially in women, older people and people with diabetes. The British Heart Foundation lists the following warning signs:

• Chest pain or pressure that may feel like a tightness, heaviness or squeezing.
• Pain that spreads to the arm (often the left), jaw, neck, back or stomach.
• Sudden sweating, dizziness, light-headedness or feeling sick.
• Shortness of breath.
• Sense of impending doom (‘something is very wrong’).

Call 999. While waiting, sit down and rest. If the person is conscious and not allergic, chew (don’t swallow whole) one adult 300 mg aspirin. Do not give if under 16 or asthmatic without prior advice.

Sepsis kills around 48 000 people in the UK every year — more than breast, bowel and prostate cancer combined. The UK Sepsis Trust’s adult SEPSIS red-flag list:

• Slurred speech or confusion.
• Extreme shivering or muscle pain.
• Passing no urine in a day.
• Severe breathlessness.
• It feels like you’re going to die.
• Skin mottled or discoloured.

Call 999 or go straight to A&E and say the word ‘sepsis’. UK A&E departments are required to start the ‘Sepsis Six’ bundle within one hour of suspicion.

A mental-health crisis is no less of an emergency than a physical one. Call 999 or go to A&E if:

• Someone has attempted suicide or self-harm requiring medical care.
• Someone has taken an overdose or harmful substance.
• Someone is at imminent risk of harming themselves or another person.
• Someone is psychotic, manic or so distressed that they cannot keep themselves safe.

For an urgent crisis that is not immediately life-threatening, call NHS 111 and choose option 2 to be put through to your local 24/7 mental-health crisis service. See our full guide on A&E for mental-health emergencies.

The Royal College of Paediatrics & Child Health (RCPCH) lists the following child-specific 999 red flags:

• A non-blanching rash (doesn’t disappear under glass pressure).
• A baby’s soft spot bulging when calm and upright.
• Pale, mottled, blue or unusually cold skin, especially of hands and feet.
• Very rapid breathing or grunting noises while breathing.
• Persistent vomiting in babies, especially if green (bile).
• A first-ever fit or seizure.
• Floppy or unresponsive baby — won’t wake up properly.
• Severe headache with neck stiffness or photophobia.
• Inconsolable crying for hours in a baby under 6 months.

See our companion guide: Going to A&E with children.

The NHS would much rather you called and got reassurance than waited and got worse. If you are uncertain:

1. Call NHS 111 — free, 24/7. They will triage and either give you advice, book you in to a UTC, dispatch a paramedic, or tell you to go to A&E.
2. Use the 111 online service for non-urgent symptoms (faster than waiting on the phone).
3. For non-urgent advice in working hours, your GP and a pharmacist are both excellent first calls.

Looking up your local A&E first? Browse our A&E directory or use find A&E near me.