How to get help in a medical emergency in Germany

Call 112 when there is immediate danger to life, risk of permanent damage, severe breathing difficulty, unconsciousness, suspected stroke or heart attack, major bleeding or trauma, serious burn, severe allergic reaction, seizure that is prolonged or unusual, or another rapidly dangerous condition. The call is free and operates around the clock. If uncertain whether the situation is life-threatening, describe it to 112 rather than losing time through self-triage.

Match the route

The Federal Ministry of Health portal publishes the current official routing, including 112, 116117, poison centres, 116123, and pharmacy rotas (Emergency numbers). Save the numbers, but use local Land and municipal services where the portal directs because poison and crisis structures differ.

A Notaufnahme is not a substitute for routine practice. Patients are triaged by clinical urgency, so a stable person can wait while later arrivals are treated first. Conversely, do not route a possible stroke, heart attack, severe injury, or suicidal emergency through an online booking or routine appointment.

For a child, pregnancy, mental-health crisis, violence, sexual assault, poisoning, or hazardous-material event, state that branch at the first contact. Do not give food, drink, medicine, induce vomiting, restrain someone, or enter a hazardous area unless the dispatcher or qualified professional directs it.

Residents, visitors, students, workers, families, and uninsured people use the same urgency decision. Insurance changes billing, not the need to seek life-saving help. Use the routine route only when symptoms are stable, no red flags exist, and waiting is clinically safe.

Emergency access begins with the person's condition and location. A dispatcher or clinical team decides resources and priority from symptoms, mechanism, consciousness, breathing, circulation, age, pregnancy, mental state, exposure, and risk. A health card, passport, EHIC, private policy, or payment guarantee can help later, but no one should search for documents while a life-threatening condition goes untreated.

Identify special branches early

For a baby or child, give exact age or weight if known, breathing, alertness, fever, rash, injury, possible ingestion, and caregiver contact. For pregnancy, give estimated weeks, bleeding, pain, contractions, fluid loss, fetal movement concern, prior complications, and intended maternity unit if known. For mental-health crisis, state suicidal thoughts, plan or means, violence risk, severe confusion, substances, missing medication, and whether the person is alone. Call 112 for immediate danger and 110 when active violence or security requires police.

For poison exposure, identify product or substance, container, amount, time, route, symptoms, age and weight, and first aid already attempted. Keep packaging safely. Use the Land poison centre for non-life-threatening specialist advice and 112 for severe symptoms, unconsciousness, breathing difficulty, seizure, or other immediate danger. Never induce vomiting unless specifically instructed.

A statutory resident should present the electronic health card or substitute certificate when feasible. A private patient should give insurer and policy details but confirm later invoice submission. An EU-covered temporary visitor can use EHIC for medically necessary public-system care under host-state terms. EHIC does not cover private healthcare, planned treatment, rescue, or repatriation, and a person without the physical card may have to pay and seek reimbursement (Temporary EU health cover). Travel-insurance terms can require prompt assistance-line notice, but never before emergency contact.

A third-country visitor or uninsured person can receive emergency assessment and then face an invoice or payer investigation. Ask the hospital social service or billing team to identify statutory, private, travel, accident, welfare, or other responsibility. An occupational accident may use the statutory accident-insurance pathway, so state that it occurred at work or on the direct commute.

For planned follow-up after stabilisation, provider approval and insurer authorisation matter. A purely private clinic can create costs that an ordinary statutory fund does not cover, while privately owned approved hospitals can treat statutory patients. Confirm before non-emergency transfer or elective admission.

Prepare a one-minute emergency summary on paper and securely on the phone: legal name and date of birth, emergency contact, insurer and member number, major diagnoses, allergies, medicines with dose and last use, implants, pregnancy, communication needs, and important advance directive or representative. Keep it current. Do not include unnecessary financial or identity data on an unlocked card.

During the event

The immediate facts are exact location, callback number, what happened, when, symptoms, consciousness, breathing, major bleeding, hazards, number of people, age, and special risks. For medicine or poison exposure, retain the package. For trauma, describe mechanism and do not move the person unless danger or dispatcher instruction requires it. For violence, protect safety and preserve clothing or other evidence only where this does not delay care.

Bring health card, identity, EHIC, private or travel policy, medication list, vaccination evidence where relevant, and prior findings only if immediately available. A companion should not leave an unstable person to collect paperwork. Give responders the current medicine and allergy information even if spelling is uncertain, and show the container or photograph when possible.

After care, collect the emergency or discharge letter, diagnoses, findings, imaging access, laboratory results, procedure and anaesthesia notes where relevant, medicine reconciliation, prescriptions, incapacity certificate, wound or equipment instructions, warning signs, follow-up referral, named receiving practice, transport record, and itemised invoices. Record when and where the person was triaged, treated, transferred, and discharged and who received valuables or keys.

Patients may inspect their record and request copies. The first copy is free, originals remain with the provider, and the record normally must be retained for at least ten years after treatment (Patient records). Request the emergency episode specifically and preserve the request receipt. Corrections should be added transparently, not achieved by deleting the original entry.

For reimbursement, keep EHIC or policy proof, assistance case number, ambulance and hospital bills, itemised fee details, payment receipts, prescriptions, referral, medical-necessity evidence, and insurer decisions. Translate only what the insurer or next clinician needs and preserve originals. Finish with a chronology of symptom onset, calls, dispatch instructions, transport, treatments, medicine changes, discharge, later deterioration, costs, and every deadline.

Act in a fixed order. If more than one person is present, assign the call, access, first aid, documents, and crowd or child care.

The emergency sequence

1. Make the scene safe. Do not enter traffic, fire, gas, electricity, violence, water, or chemical danger. Call the appropriate emergency service.
2. Call the correct number. Use 112 for life threat or lasting-harm risk, 110 for immediate police danger, and 116117 for urgent non-life-threatening medical need. Say the exact location and callback number first.
3. Describe facts. State what happened, number and age of patients, consciousness, breathing, bleeding, symptoms, start time, pregnancy, poison, violence, and hazards. Say which languages are possible. Do not hang up until told.
4. Follow instructions. Begin dispatcher-guided first aid, send someone to meet responders, unlock access, secure pets, gather medicine packages, and keep the line free. Do not give food, drink, or medicine unless directed.
5. Avoid unsafe transport. Do not drive a person at risk of collapse, severe deterioration, impaired consciousness, major bleeding, or dangerous behaviour. The dispatcher decides appropriate response.
6. Hand over clearly. Give the symptom timeline, medicines, allergies, medical history, first aid, and change since the call. Bring documents only if ready.
7. Participate in discharge. Ask what was found, what remains uncertain, medicine starts and stops, wound or equipment care, activity and driving limits, red flags, result ownership, and exact follow-up. Use teach-back: repeat the plan in your own words.
8. Complete the next step. Fill prescriptions, arrange a safe ride and supervision, contact the Hausarzt or specialist, notify insurer where required, and return or call 112 if the stated red flags occur.

Triage in Notaufnahme is based on clinical urgency. Do not leave silently because others appear to be seen first. Tell staff about worsening pain, breathing, confusion, bleeding, weakness, rash, or mental state. If choosing to leave, request reassessment and safe instructions.

Consent should still be understandable whenever the emergency permits. Immediate lifesaving care can proceed when a patient cannot consent and delay would endanger them. State interpreter needs; a family member is not always suitable for complex or sensitive decisions. For planned procedures after stabilisation, ask about alternatives, major risks, cost, and second opinion.

After transfer between facilities, confirm that records, imaging, medicines, valuables, and contact details travelled with the patient. After discharge, do not assume the hospital automatically books every appointment or communicates every result.

Calling 112 and 116117 is free, but that does not mean every resulting service is free. Ambulance, emergency physician, hospital, outpatient treatment, medicine, transport, and optional services each use their own billing rule. Never decline a needed emergency response solely because the final price is unclear. Resolve the payer after immediate safety.

Identify the payer

A statutory member usually has medically necessary approved emergency treatment settled through GKV, subject to statutory co-payments and coverage rules. Covered transport generally depends on medical necessity and the prescribed or emergency route. If an invoice arrives, send the member and event evidence to the fund and ask whether the provider billed the wrong payer or whether a patient share applies. Do not pay a vague duplicate bill without an itemisation.

Covered inpatient hospital care ordinarily carries a EUR 10 co-payment for each calendar day, limited to 28 days in the calendar year. Age, maternity, prior days, exemption, rehabilitation, and other branches can change the result. The ministry publishes the current statutory co-payment table (GKV co-payments). Preserve receipts toward the annual burden limit and request exemption or reimbursement from the fund when eligible.

Private patients commonly receive itemised invoices and claim under tariff terms. The policy can limit ambulance type, private clinic, physician fees, aids, or foreign treatment, so notify the insurer after stabilisation and obtain case references. A hospital may use direct billing or assignment, but verify what remains personally owed. A private room or elective physician service is not automatically medically necessary emergency care and normally requires a separate agreement.

EHIC gives covered temporary visitors access to medically necessary public-system care under German patient terms, but excludes private healthcare, planned treatment, rescue, and repatriation. A missing card can mean upfront payment and later reimbursement. Travel insurance may cover additional risks but can require prompt assistance notification and original evidence. Keep policy, call record, case number, medical report, itemised invoice, and receipt.

An uninsured or status-disputed person may receive bills from ambulance, hospital, physicians, and pharmacy. Ask hospital social service and billing to test GKV, prior-insurer, accident, welfare, asylum, cross-border, or travel responsibility. Request an itemised statement and realistic payment handling while the decision is pending. Interpreter, repatriation, companion travel, damaged property, and private transfer can be uncovered. Avoid paid intermediaries promising guaranteed reimbursement.

Emergency treatment has multiple clocks. Dispatch prioritises resources by reported danger. Notaufnahme triage ranks clinical urgency and reassesses change, not arrival order. Diagnostics, specialist review, bed availability, and transfer can extend a stay. Ask staff what change should be reported immediately rather than demanding a promised queue time.

Control each transition

At ambulance handover, give symptom onset, trend, treatment, medicines, allergies, risks, and contact. At hospital transfer, confirm destination and that key records and valuables follow. If the person cannot communicate, identify the lawful representative or emergency contact without assuming a companion can consent to everything.

Before discharge, obtain written diagnosis or working diagnosis, unresolved possibilities, results, pending tests, medicine reconciliation, prescription, wound or device instructions, activity and driving limits, food or fluid advice, certificates, follow-up provider and timing, and red flags. The next clinician should be named where possible. If no practice is available within the required timeframe, use the hospital contact, 116117, insurer, or Hausarzt to arrange the alternative.

Prescription use, medicine supply, sick-note reporting, wound review, suture removal, imaging review, specialist appointment, and rehabilitation each have different timing. Fill urgent medicines promptly and ask the pharmacy about availability or out-of-hours supply. Do not stretch a medicine, double a missed dose, or restart a stopped treatment without clinical advice.

Visitors should notify the travel insurer as soon as safely possible under the policy, preserve its case number, and obtain any medical-fitness or repatriation approval before arranging expensive transport. EHIC reimbursement and private claims require complete records. Residents should submit private invoices, statutory transport documents, and exemption receipts within the relevant contract or fund rules. An invoice due date, insurer submission limit, billing objection, complaint, malpractice limitation, and police evidence process are separate.

If symptoms worsen after discharge, use the red-flag instruction. Call 112 when danger returns, 116117 for urgent non-life-threatening deterioration, or the named provider for routine follow-up. A move, job change, graduation, separation, or departure should trigger an updated emergency summary, new insurer and provider details, medicine supply, and local service search.

Keep proof of every call, submission, appointment, prescription, result request, and payment. A pending complaint or insurance claim does not make it clinically safe to wait and does not automatically pause another deadline.

If 116117 receives a life-threatening presentation, state the deterioration and call 112. If a person self-drove and becomes unsafe, stop in a safe place and call 112 rather than continuing. If someone left Notaufnahme without instructions, contact the department or 116117 for a safe plan and call 112 for red flags. Correct the clinical risk before preparing a complaint.

Build the issue file

Write the symptom and event timeline, calls, numbers used, dispatch advice, arrival and triage, worsening reported, tests, treatments, staff roles, transfer, discharge, medicine, later outcome, costs, and desired correction. Preserve phone logs, messages, witness notes, photographs, packages, records, discharge letter, invoice, payment, insurance decisions, and follow-up findings. Request the complete treatment record promptly. Keep facts separate from conclusions.

For a denied or delayed emergency assessment, first ask the provider for immediate reassessment when symptoms persist. Later, ask hospital complaint management for a written review. Hospitals must maintain accessible complaint systems, and patient advocates can help. Professional-conduct issues go to the Land Chamber of Physicians; statutory-provider duty issues can go to the regional KV; systemic hospital concerns can reach the relevant Land supervision; privacy issues go to the competent data authority. The official patient complaint guide maps these routes (Complaints about treatment).

For an unexpected invoice, request itemised ambulance, hospital, physician, pharmacy, and elective-service charges. Compare date, patient, service, payer, statutory status, EHIC, travel case, tariff, and payments. Send focused evidence to the provider and insurer and challenge duplicate or unsupported lines in writing. Pay or arrange amounts that are clearly owed rather than ignoring the entire bill. A billing complaint does not automatically stop collection or limitation.

For suspected treatment error, obtain corrective care first. Request records and imaging, document new findings, and ask the statutory fund for support where applicable. Chamber expert or arbitration procedures may help, but compensation and urgent injunctions can require legal advice. Do not alter medical evidence or secretly record conversations without legal advice.

Use UPD or another independent patient adviser to choose a route. Contact a medical-law lawyer promptly for death, serious lasting injury, lost evidence, large cost, limitation, or court process. Police are appropriate for violence, theft, fraud, or another suspected offence, not as a substitute for clinical review. Every escalation should state the concrete outcome: renewed care, corrected record, itemised bill, reimbursement, professional review, evidence preservation, or compensation.