Emergency Services

The Key Numbers You Must Know

Germany has a well-structured emergency system, but it can be confusing if you don't know which number to call. Three numbers matter most, and knowing the difference can save your life — or save you hours of unnecessary waiting.

When to Call 112

Call 112 for any situation that is immediately life-threatening or could become life-threatening without rapid medical intervention. The Leitstelle (dispatch center) will send the appropriate resources — ambulance, Notarzt, or fire brigade.

• Chest pain or suspected heart attack: Crushing chest pressure, pain radiating to arm or jaw, shortness of breath, cold sweats
• Stroke symptoms: Sudden facial drooping, arm weakness, speech difficulty (use the FAST test: Face, Arms, Speech, Time)
• Severe bleeding: Any bleeding that won't stop with direct pressure, or arterial bleeding
• Loss of consciousness: Person is unresponsive, regardless of the cause
• Severe allergic reaction (anaphylaxis): Swelling of throat/tongue, difficulty breathing, drop in blood pressure
• Serious accidents: Car crashes, falls from height, major burns, electrocution
• Breathing difficulty: Severe asthma attack, choking, drowning, any situation where the person can't breathe adequately
• Seizures: Especially first-time seizures or seizures lasting more than 5 minutes
• Severe pain: Sudden, extreme abdominal pain, worst headache of life

When to Call 116117

Call 116117 when you have an urgent medical issue that is notlife-threatening, but you need help outside your GP's office hours. This is the number for the ärztlicher Bereitschaftsdienst (medical on-call service), run by the Kassenärztliche Vereinigung (KV).

• High fever at night: Especially in children, when your pediatrician is closed
• Severe back pain: Acute episodes that started suddenly but aren't indicating paralysis
• Infections requiring treatment: Urinary tract infections, ear infections, worsening respiratory infections
• Vomiting or diarrhea: Persistent and concerning, especially with signs of dehydration
• Minor injuries: Sprains, minor cuts needing stitches, suspected (non-displaced) fractures
• Anything urgent but not life-threatening: When you can't wait for your GP to open but don't need an ambulance

When you call 116117, you'll be triaged by phone. Depending on the situation, they may:

1. Send a doctor to your home (Hausbesuch)
2. Direct you to the nearest Bereitschaftspraxis (after-hours GP clinic)
3. Give you medical advice over the phone
4. In serious cases, transfer you to 112

Rettungsdienst (Ambulance Service)

Germany's emergency medical service is one of the most advanced in the world, with a unique system that includes emergency physicians responding directly to the scene. Here are the key vehicles you might encounter:

• Rettungswagen (RTW): The standard ambulance, staffed with Notfallsanitäter (paramedics) who have 3 years of training. They handle most emergency transports and can administer many treatments on scene.
• Notarzteinsatzfahrzeug (NEF): A separate vehicle carrying an emergency physician (Notarzt). Deployed alongside the RTW in serious cases. The Notarzt can perform advanced procedures — intubation, chest drainage, emergency medication — that paramedics cannot. This physician-on-scene model is a hallmark of the German system.
• Krankentransportwagen (KTW): Non-emergency medical transport for patients who need to be transported lying down but aren't in an emergency situation — e.g., hospital transfers, dialysis transport, or patients who can't travel by normal means.
• Rettungshubschrauber (RTH): Helicopter emergency medical service, always carrying a Notarzt. Used for remote locations, severe trauma, or when road transport would take too long. Germany has one of the densest helicopter EMS networks in the world, with over 80 bases ensuring coverage within 15 minutes flight time.

Costs and Insurance Coverage

One of the biggest fears people have about calling an ambulance is the cost. In Germany, the good news is that emergency services are covered by health insurance — both GKV and PKV. You should never hesitate to call 112 because of cost concerns.

Important for non-emergency transport: If you need a KTW (e.g., for regular dialysis, hospital transfer, or getting to a rehab facility), your doctor must issue a Verordnung einer Krankenbeförderung (transport prescription). Without this, your Krankenkasse may not cover the cost, and non-emergency ambulance transport can cost €200-500+ out of pocket.

Notaufnahme (Emergency Room)

German hospital emergency rooms use a standardized triage system to ensure the sickest patients are seen first. Understanding this system will help you manage expectations about wait times.

Manchester Triage System (MTS)

Most German Notaufnahmen use the Manchester Triage System to prioritize patients. When you arrive, a trained nurse assesses your condition and assigns you a color category:

What to Expect at the Notaufnahme

1. Patientenaufnahme (Registration): Bring your Versichertenkarte (health insurance card) and ID. You'll be registered and your personal details recorded.
2. Triage: A nurse assesses your condition and assigns a priority category. Be honest and specific about your symptoms.
3. Waiting: Unless you're red or orange, expect to wait. Green and blue patients can wait 2-4+ hours on busy nights (Friday/Saturday evenings are worst).
4. Treatment: You'll be seen by a doctor, examined, and may receive tests (blood work, imaging, ECG).
5. Discharge or admission: Most ER patients are treated and sent home with a Entlassbrief (discharge letter) for their GP. Some are admitted to the hospital.

Bereitschaftspraxis (After-Hours GP Clinic)

The Bereitschaftspraxis is one of Germany's best-kept secrets for after-hours care. These are GP-style clinics that operate outside normal office hours, typically run by the Kassenärztliche Vereinigung (KV).

• Location: Usually located at or adjacent to hospitals, making it easy to be referred to the Notaufnahme if needed
• Hours: Typically evenings (after 19:00), weekends, and public holidays — exact hours vary by region
• Wait times: Significantly shorter than the Notaufnahme for non-emergency issues — often 30-60 minutes vs. 3-4+ hours in the ER
• Staffing: Regular GPs (Vertragsärzte) taking turns on call, so you get proper primary care attention
• Coverage: Fully covered by GKV and PKV — same as a normal GP visit
• What they handle: Fever, infections, back pain, minor injuries, prescription refills, earaches, rashes — anything a GP would normally see

Dental Emergencies

Dental pain doesn't care about office hours. Here's how to get emergency dental care in Germany:

• Zahnärztlicher Notdienst: Emergency dental on-call service, available evenings, weekends, and holidays. This is separate from the regular medical Bereitschaftsdienst.
• How to find one: Call 116117, or check your regional Zahnärztekammer (dental association) website. Many cities have a dedicated dental emergency number or website listing today's emergency dentist.
• What's covered: Emergency treatment (pain relief, temporary fillings, abscess drainage, re-cementing crowns) is covered by GKV. Definitive treatment (permanent fillings, root canals) usually follows with your regular dentist.
• Knocked-out tooth: Place the tooth in milk or a Zahnrettungsbox (tooth rescue box — available at many pharmacies), and get to a dentist within 30-60 minutes for the best chance of reimplantation.

Psychiatric Emergencies

Mental health crises are medical emergencies too. Germany has several resources for psychiatric emergencies:

• Telefonseelsorge: Call 0800 111 0 111 or 0800 111 0 222 — free, anonymous, 24/7 crisis hotline. Trained counselors provide immediate support for suicidal thoughts, acute distress, and emotional crises. Also available online and via chat.
• Krisendienst: Regional psychiatric crisis services available in most larger cities. They provide immediate phone counseling and can send mobile crisis teams to your location. Berlin, Munich, Hamburg, and other cities have well-established Krisendienste operating 24/7.
• Sozialpsychiatrischer Dienst (SpDi): Run by local health authorities (Gesundheitsamt), they provide outreach, home visits, and can help coordinate care. Available during business hours in most cities and Landkreise.
• Psychiatrische Notaufnahme: Most larger hospitals with a psychiatry department have a psychiatric emergency room, available 24/7. You can go there directly or be referred by 112/116117.
• Voluntary vs. involuntary admission: You can always voluntarily present to a psychiatric ER. Involuntary admission (Unterbringung) under PsychKG (state psychiatric laws) requires that a person poses an acute danger to themselves or others, and must be ordered by a judge within 24 hours. Police and Ordnungsamt can initiate temporary holds.

Poison Control (Giftnotruf)

Germany has regional poison control centers (Giftinformationszentren) that provide 24/7 expert advice on poisoning and toxic exposures. If you suspect poisoning — whether a child swallowed cleaning products, a medication overdose, or exposure to toxic substances — call your regional Giftnotruf immediately.

Emergencies Abroad

If you're insured in Germany and have a medical emergency while traveling, here's what you need to know:

Within the EU/EEA: EHIC

• European Health Insurance Card (EHIC): Your GKV Krankenkasse issues this card (often printed on the back of your Versichertenkarte). It entitles you to medically necessary treatment in any EU/EEA country and Switzerland under the same conditions as locals.
• What it covers: Emergency treatment, medically necessary care that can't wait until you return to Germany. It does not cover planned treatment abroad or repatriation.
• How it works: Present your EHIC at any public healthcare provider. You may need to pay upfront in some countries and claim reimbursement from your Krankenkasse later.

Outside the EU: Travel Insurance

• GKV does NOT cover you outside the EU (with very few exceptions). A private Auslandsreisekrankenversicherung (travel health insurance) is essential.
• Cost: Only €8-15/year for excellent coverage — one of the cheapest and most important insurance products you can buy.
• What it covers: Emergency medical treatment, hospital stays, emergency dental care, and — critically — medical evacuation (Rücktransport) back to Germany, which can cost €50,000-100,000+ without insurance.
• Handling bills abroad: Pay upfront, collect all receipts, invoices, and medical reports, then submit claims to your travel insurer after returning. Always notify your insurer as soon as possible (most require notification within 24-48 hours of emergency treatment).

Erste Hilfe (First Aid)

In Germany, first aid isn't just encouraged — it's a legal obligation. This is an important cultural and legal point that every resident should understand.

Legal Duty to Help

Under § 323c StGB (German Criminal Code), failing to provide assistance in an emergency — unterlassene Hilfeleistung — is a criminal offense punishable by up to one year in prison or a fine. You are legally required to help if:

• Someone is in an emergency situation (accident, medical crisis, etc.)
• Help is needed and you are able to provide it
• Helping is reasonable and doesn't put you in serious danger

"Helping" at minimum means calling 112 and staying with the person until help arrives. You don't need to perform CPR if you don't know how — but you must at least call for help and not walk away.

Ersthelfer Protections

German law protects Ersthelfer (first responders/bystanders who help). If you provide first aid in good faith and accidentally cause harm, you arenot liable. The Berufsgenossenschaft (statutory accident insurance) even covers first aiders — if you injure yourself while helping someone (e.g., you hurt your back performing CPR), your treatment costs are covered.

First Aid Courses (Erste-Hilfe-Kurs)

• Required for your driver's license: Every person applying for a German Führerschein must complete a certified Erste-Hilfe-Kurs (9 teaching units, about 7.5 hours). This ensures all German drivers know basic first aid.
• Providers: DRK (German Red Cross), ASB, Johanniter, Malteser, and various private providers. Courses cost €30-50 and are widely available.
• Workplace requirement: Employers must ensure enough staff are trained as Ersthelfer (first aiders) — at least 1 per 20 employees in offices. Your employer pays for this training.
• Refresher courses: While the driver's license course never expires, workplace first aid certification must be renewed every 2 years. Experts recommend refreshing your skills regularly regardless.