Making the Mostof the Ambulance Service～ When do we need an ambulance? ～<Purpose of this document>
In recent years, there has been an increase in the number of times ambulances get called out
and the number of people being transported by ambulance. It is also taking longer for
emergency crews to reach their destinations.
The fact is that around half the people transported by ambulance have minor conditions inwhich hospitalization is unnecessary.
Timely and appropriate use of ambulances is necessary to make effective use of the limited
number of ambulances in the community and to ensure that ambulances arrive as quickly as
possible to injured and ill persons with urgent symptoms.
For this reason, we have created this document entitled “Making the Most of the Ambulance
Service – When do we Need an Ambulance?” The document contains information such as“Points to communicate when calling an ambulance”, “Conditions under which you should callan ambulance without delay” (since the patient may have a serious illness/injury), “How to callan ambulance” (instructions for when you actually have to do so) and other points, in order tohelp you decide whether a situation requires an ambulance or not in a confusing situation.

Fire and Disaster
Management Agency

https://www.fdma.go.jp/publication/portal/(Please see our website)(Issued October 2022)

Points to communicate when calling an ambulance
Dial 119 to call an ambulance
Emergency treatment is important in order to save lives.
If emergency treatment is required, the emergency call center staff
receiving the 119 call may ask you to provide appropriate emergency
treatment and instruct you over the telephone how to implement it.

Ask somebody
to bring the AED
here!

It always takes some time for the ambulance to arrive.
Please learn the correct way to implement these emergency
treatment measures.
They may save the life of a loved one.

Average 8.9
minutes(2020)Your local fire department offers classes in practicing emergency
treatment measures.
You can find the phone number on your town/city hall website.

If there are other helpers available, send them out tothe place where the ambulance is due to arrive.
This will help the crew reach you more quickly.

This waypleaseIt is helpful if you can prepare the following things when calling an ambulance・ Passport
・ Health insurancecard/patientregistration card
・ Cash・ Shoes・ Current medicationand schedule(For young children)
・ Maternal/childhealth record
・ Paper diapers
・ Drinking bottle
・ TowelHealthinsurance card

Patient
registration card

Shoes

Medicine

CashMaternal/childhealth record

Paper diapers

DrinkingbottleCurrent
medication andschedule

Towel

When the ambulance arrives, communicate the following information:
・ The conditions under which the accident or illness
occurred
Chronic disease is・ Any changes before the ambulance arrived●●●
Family hospital is・ Any emergency measures engaged in▲▲▲・ Information about the person who is sick or injured(chronic disease, family hospital and clinic, usual 、Usual medication is
medicine, doctor's instruction, etc.).
■■■

2* It is useful to keep a noteof chronic disease, family
hospital and clinic, etc.

Situations in which you should call an ambulance without hesitation

If you experience any of these sudden symptoms,
please call 119 without hesitation!!
Elderly

Face

Head

● Sudden, strong
headache● Half your face isdifficult to move,or has pins andneedles● Sudden high fever● Suddenly lightheaded
and unable to stand● Your mouth or face istwisted when you smile● You cannot speak properly

Chest
and
back

● Sudden sharp pain

● Your sight is impaired● Sudden loss of breath ordifficulty breathing● Surroundings appear in● Pain started after a trip

double vision● Pain moving around your
body

Hands
and
Feet

● Sudden pins and needles

Stomach● Sudden sharp pain

● Sudden loss of strength
in one leg or arm● Vomiting blood

Problems withconsciousness

Nausea● Unconscious (no response) or
incomplete consciousness(confused or vague)● Strong nausea
accompanied by cold
sweatsSpasm

Swallowing● Continuous spasm● Object stuck in throat

Injury/burn

Accident● Injury that includes
significant blood loss

● Have been in a traffic
accident or fallen,
suffered strong impact
from falling● Burns across a widearea
◎Any other situation in which the patient’s condition is altered or unusual.◎
Note that elderly people may have difficulty in recognizing symptoms.

When in doubt, consult the family doctor!
**

If you have fever or other symptoms, call a Coronavirus Call Center or visit a fever outpatient
clinic/family doctor/regional outpatient clinic or laboratory center as soon as possible.
If you are unsure whether to call 119, contact your nearest emergency advice center (#7119, etc.).
3

They may indicate a serious illness or injury.
Adult

Face
● Half your face
is difficult to
move, or has
pins andneedles● Your mouth or face istwisted when you smile● Sudden, strong
headacheHead● Sudden high fever● You feel so unstablethat you cannot standwithout support● Sudden sharp pain
● Sudden loss of breath ordifficulty breathing● You cannot speak properly● Your sight is impaired

Chest
and
back

● You suddenly have double
vision● A sense of tightness orpressure in the chest, lasting 2
or 3 minutes● Your face is a strange color● Pain moving around your body

Hands
and
Feet

● Sudden sharp pain

Stomach● Persistent strong
stomach pain

● Sudden pins and needles● Vomiting blood● Sudden loss of strength
in one leg or arm● Blood in feces or blackish
feces

Problems withconsciousness

Nausea● Strong nausea accompanied bycold sweats● Unconscious (no response) or
incomplete consciousness (confusedor vague)● Sense of exhaustion

Swallowing

Spasm● Patient has swallowed an
object, has difficulty
breathing, or is unconscious● Continuous spasm● Spasm ends, but
consciousness does not
returnAccident● Have been in a traffic accident (strong
impact)● Have been submerged in water● Have fallen from a height

Injury/burn● Injury that includes
significant blood loss
● Burns across a wide area

◎Any other situation in which the patient’s condition is altered or
unusual.
*If you have fever or other symptoms, call a Coronavirus Call Center and consult with them. (Especially for pregnant
women and those with underlying medical conditions, if you have symptoms such as fever, call a Coronavirus Call
Center or visit a fever outpatient clinic/family doctor/regional outpatient clinic or laboratory center as soon as possible.)*

If you are unsure whether to call 119, contact your nearest emergency advice center (#7119, etc.).
4

Situations in which you should call 119
without hesitation!
Child (up to the age of 15)

Face

Head

● Head hurts,
spasm occurs● Lips purple● Has hit head,accompanied bycontinuous blood
loss, loss of
consciousness
or fitting● Facial color clearly
poor

Chest

Stomach● Sharp coughing,wheezing, breathingdifficulties● Strong diarrhea or
nausea, not eating or
drinking,
consciousness
impaired● Breathing weak

Hands
and
Feet

● Suffering from strong
stomach pain
● Repeated nausea● Legs or arms rigid● Blood in feces

Problems withconsciousness

Spasm

Swallowing● Unconscious (noresponse) or incomplete
consciousness (confusedor vague)● Continuously spasm● Spasm ends, but
consciousness does not
return● Patient has swallowed
an object, has difficulty
breathing, or is
unconscious

Hives

Burns

Accident● Bitten by an insect, bodycovered in hives andfacial color poor

● Severely painfulburn● Burns over a widearea

● Have been in a traffic
accident (strong impact)● Have been submerged inwater● Have fallen from a height

Infants under 3-month-old● Any situation in which baby’s
state is altered.

◎ Other unusual or strange behavior from themother or father’s point of view.
**

For children of elementary school age and younger who have symptoms such as fever, call a Coronavirus Call Centeror visit a fever outpatient clinic/family doctor/regional outpatient clinic or laboratory center as soon as possible.
If you are in doubt, call your nearest telephone advice line. You can use #8000 for the Emergency Medical Telephone
Advice for Children (mainly on holidays and at night) and #7119 for 119 calls.
5How to call an ambulance
On receiving a 119 call, emergency call center staff will ask certain questions to establish theneed for an ambulance callout. If the situation is high-priority, the ambulance will bedispatched before all these questions have been asked.

Please speak slowly and do not panic.
119, is it a fireor a medical
emergency?

Communicate the fact that it
1 is a medical emergency.
If you call 119, the first thing
you say should be“ medical
emergency”.

Medical emergency

What's youraddress?

Give the address you want

2 an ambulance to come to.

Please give the name of thecity/town/village first. If you do not know
the address, describe a nearby building
or intersection.

The address is
XX city ….

What has
happened?

Communicate the
3 symptoms of the patient.

My father said
his chest hurt,
and he hascollapsed

Firstly, state who has experienced
what symptoms, and how they are
now, clearly and simply. State what
you know about their consciousness
and breathing.

How old is thepatient?

Communicate the age of
4 the patient

He’s 65

State the patient's age. If you do
not know it, give an approximation(“in his 60s”).

Please give me yourname and contact details

Give your name and5 contact details
Give your name, and a phone number
you can be reached on after the 119 callends.
The crew may contact you if theycannot find your location, etc.

My name is
YY and myphone number
is ZZ.
-In addition to this, call center staff may ask for more details, information about chronic
disease, family hospital, etc. Please give whatever information you can.
The examples given above are the general flow of a conversation in a situation of this type.
6

If you are unsure, contact your nearest emergency advice centerIf you become ill or injured suddenly, you may be unsure whether to call an ambulance, or go
to hospital yourself. You may also be unsure which hospital would be most suitable.

Out-of-hours
emergency
entrance →Your local prefectural, city, town or village emergency advice center is there for justthis kind of situation. Please feel free to contact them.
For example, the following telephone advice lines are available(as of October 2022).
#7119 Emergency Advice Center (Tokyo)
Emergency Peace of Mind Center(Sapporo City area, Miyagi Prefecture, Ibaraki Prefecture, Saitama
Prefecture, Yokohama City, Niigata Prefecture, Gifu City area, Kyoto
Prefecture, Osaka Prefecture, Kobe City area, Nara Prefecture,
Tanabe City area, Tottori Prefecture, Hiroshima City area, Yamaguchi
Prefecture, Tokushima Prefecture, Kochi Prefecture, Fukuoka
Prefecture)#8000 Emergency Medical Telephone Advice for Children(Available in all prefectures)

Q-Suke, a nationwide emergency consultation app▪ Created by the Fire and Disaster Management Agency, “Q-Suke” is an
app that helps people who are unsure of when to go to the hospital orwhether an ambulance is necessary in the event of a sudden illness or
injury, by simply selecting the symptoms on the screen andresponding according to the level of urgency.
▪ The app is free to download and use.
< Created in cooperation with Osaka University Hospital. (Patent No.
6347901) >the Ministry of Internal Affairs and Communications Fire and Disaster
Management Agency “Q-Suke” information site
https://www.fdma.go.jp/neuter/topics/filedList9_6/kyukyu_app.html
7

Emergency medical inspection
Even if the symptoms are not urgent, some people call an ambulance simply because they have no transport, they do
not know which hospital to go to, it is more convenient, or because they feel they are in trouble.
Sometimes people visit an out‐of‐hours emergency clinic at night or on a holiday because they cannot take time off
during the week, they are busy during the day, or they have to go to work the next day.
Ambulances and emergency medical staff are a limited resource. Please think about whether you really need an
emergency consultation, in order to ensure that the service is available to those who do.

Ambulances have been called in these situations ～ Do you really need an ambulance? ～・ An itchy mosquito bite・ Scheduled to go into hospital today, so wanted a lift…

・ Sunburn after sea bathing, making the skin burn・ A paper cut on the finger, which has stopped bleeding…

・ Had called a home helper who did not come, so called an
ambulance…

・ The medicine the patient received at hospital has run out

・ Didn’t want to wait long at hospital, so called an ambulance

It is important to ensure that emergency medics can be dispatched to emergency cases inorder to save lives.
P‐A tiered response
Joint callout of
pumper andambulance

119 callEmergency
situation

High priority
Establishing level ofpriority during the call

Establishing level ofpriority of transportation

Low priority
Ordinary callout

Need foremergency
request

Medicalfacility
Transportation by
ambulance
Selection ofdestination facility

Establishing level ofpriority of treatment

Citizen

119

Phone consultation(Emergency Peace of Mind
Center, etc.)

Phone consultation

If confused whether to call 119

Self‐diagnosis at home

Visiting on your own

Information about medical facilities

Example of phone consultation

It might be a
strokeExample of establishing level of priority of transportation

Hands/feethave pinsand needles.

Your condition is not
medically urgent.
Please could you go
to hospital by
yourself ?

Example of establishinglevel of priority during call He fell over suddenly.
He’s not breathing.

Example of establishing levelof priority of treatment

Quickly, totreatment rooms

Callout

The Fire and Disaster Management Agency uses these common criteria for deciding on levelsof priority in order to create an efficient emergency response system.
8

Reference: Current and future projections of ambulance callout
Trends in ambulance callouts and total population (Actual figures till 2020, projected figures for 2025 onwards)

1980

1985

1990

1995

2000

2005

2010

2015

Total population

2020

2025

2030

No. of ambulance callouts (in units of 10,000 cases)

Total population (in units of 10,000 people)

The number of ambulance callouts is increasing
every year!
Despite a declining population, the number of
ambulance callouts is projected to continue rising!

2035

No. of ambulance callouts*Projected population based on projections in “Future population projections for Japanese cities, towns and villages” (National Institute of Populationand Social Security Research)*The number of callouts from 2025 onward has been estimated based national ambulance callout data and do not take into account future changes in rates oftransportation or changes in social conditions.

Trends in time taken to arrive at callout, andtime taken to arrive at hospitalComparison of levels ofsickness/injury of patients taken
to hospital by ambulance (2020)

Time taken toarrive at hospitalTime taken to arrive at callout (minutes)

Time taken to arrive at hospital (minutes)

The time taken to arrive at the hospital is getting
longer every year!
The response to those who are truly needemergency care may be delayed!

Died
1.5%

Serious
8.7%

Medium
44.3%

Minor
44.3%
(no need to be
admitted to hospital)

Around 45% the people who are transported tohospitals by ambulance have minor conditions
in which hospitalization is unnecessary!
Some of these people may never have needed
to use an ambulance in the first place.

Time taken toarrive at callout

9