Why do we suggest calling 999 or going to A&E?

How the site decides

The site does not diagnose. It suggests calling 999 or going to A&E now only when you have said or confirmed one of the situations below. The advice stays on screen; you can still choose to go on finding a doctor, and tell us if things have changed.

If you feel it is an emergency for any other reason, call 999 straight away; do not wait for the site. The Fire Services Department says the ambulance service is for people who cannot get to medical care on their own; if it is not too serious, go to hospital by other means.

When we suggest calling 999 (Hong Kong official sources; heart attack signs from the UK NHS)

• Sudden numbness or weakness of one side of the face, arm or leg, or slurred speech (signs of a stroke) — Fire Services Department, Stroke; Centre for Health Protection, NCD Watch, October 2019
• Severe chest pain with tightness or a feeling of pressure in the chest — Department of Health, First Aid booklet (heart disease: send to hospital promptly)
• Chest pain that feels like squeezing, or spreads to the arms, neck or jaw (signs of a heart attack) — NHS, Heart attack; not listed item by item in Hong Kong, so the site follows the NHS and suggests calling 999. Do not drive yourself
• No breathing — Fire Services Department First Responder Programme (emergency call types handled by first responders)
• Heavy bleeding — Fire Services Department First Responder Programme
• Loss of consciousness — Department of Health, First Aid booklet

When we suggest going to A&E now (not listed item by item in Hong Kong; UK NHS used); call 999 if you cannot get there yourself or it gets worse

• Severe difficulty breathing (gasping, or not able to get words out) — NHS, Heart attack
• A headache that came on suddenly and reached its worst within about a minute (like being hit on the head) — NHS, Headaches; International Classification of Headache Disorders (ICHD-3)
• Vomiting blood, or black or bloody stools — NHS, Stomach ache
• Coughing up more than a few spots or streaks of blood, or coughing up blood with difficulty breathing, a very fast heartbeat, or pain in the chest or upper back — NHS, Coughing up blood
• Abdominal pain that came on very suddenly or is severe — NHS, Stomach ache
• A sore throat with difficulty breathing, being unable to swallow (for example drooling), or a high-pitched sound when breathing — NHS, Sore throat
• A child with a fever who is hard to wake or very drowsy, has a febrile fit for the first time, has difficulty breathing or bluish lips or skin, or has a rash that does not fade when a glass is pressed on it — NHS, Fever in children. The Department of Health First Aid booklet also says: call 999 for loss of consciousness; take a child with a febrile fit to hospital promptly
• Back pain with pain, tingling, weakness or numbness in both legs, loss of feeling around the genitals or anus, changes in the bladder or bowels (such as difficulty peeing or wetting yourself), or pain that started after a serious accident — NHS "Back pain"; the Health Bureau's Hong Kong Reference Framework also lists bladder or bowel problems, saddle numbness and worsening muscle weakness as warning signs of back pain
• A fever with a stiff neck, bright light hurting the eyes, a rash that does not fade when pressed with a glass, or sudden confusion or being very sleepy and hard to wake — NHS "Meningitis"
• Sudden confusion, or being very sleepy and hard to wake — NHS "Confusion"
• A wound with a stiff jaw, difficulty swallowing, or painful muscle spasms or stiffness — NHS "Tetanus"
• Toothache or swollen gums with difficulty breathing, speaking or swallowing, a swollen or painful eye or sudden problems seeing, a lot of swelling in the mouth, or difficulty opening the mouth — NHS "Dental abscess"
• Pain and swelling in one leg with shortness of breath or chest pain — NHS "Deep vein thrombosis"

When we suggest seeing a doctor the same day

• A baby aged two months or younger with a fever, a child with an immune problem who has a fever, feeding very poorly, a fever that persists, or signs of dehydration — Department of Health Family Health Service, Fever (see a doctor immediately)
• A baby under 3 months at 38°C or above, 3 to 6 months at 39°C or above, or a fever lasting five days or more — NHS, Fever in children (Hong Kong gives no temperature thresholds)
• Back pain with feeling hot, cold, shivery or generally unwell, or severe pain that started suddenly or is getting worse quickly — NHS "Back pain" (urgent appointment)
• Throbbing pain and swelling in one leg (calf or thigh) — NHS "Deep vein thrombosis" (urgent appointment)
• A fever with shortness of breath, or coughing up yellow or green phlegm — NHS "Pneumonia" (urgent appointment)
• A fever during or after a trip abroad — Centre for Health Protection "Malaria": seek medical advice immediately and tell the doctor about your travel

Sources

• Fire Services Department: Proper use of ambulance service https://www.hkfsd.gov.hk/eng/source/safety/uambu.htm
• Fire Services Department: First Responder Programme https://www.hkfsd.gov.hk/eng/fire_ambulance_services/responder.html
• Fire Services Department: Stroke https://www.hkfsd.gov.hk/eng/source/safety/stroke.html
• Centre for Health Protection: NCD Watch, October 2019 https://www.chp.gov.hk/files/pdf/ncd_watch_october_2019.pdf
• Department of Health: First Aid booklet https://www.chp.gov.hk/files/her/ijpacp003b_tc.pdf
• Department of Health Family Health Service: Fever https://www.fhs.gov.hk/english/health_info/child/14743.html
• NHS (UK): Heart attack https://www.nhs.uk/conditions/heart-attack/
• NHS (UK): Fever in children https://www.nhs.uk/conditions/fever-in-children/
• NHS (UK): Coughing up blood https://www.nhs.uk/conditions/coughing-up-blood/
• NHS (UK): Headaches https://www.nhs.uk/conditions/headaches/
• NHS (UK): Stomach ache https://www.nhs.uk/conditions/stomach-ache/
• NHS (UK): Sore throat https://www.nhs.uk/conditions/sore-throat/
• NHS (UK): Back pain https://www.nhs.uk/conditions/back-pain/
• Health Bureau: Hong Kong Reference Framework, common musculoskeletal problems https://www.healthbureau.gov.hk/phcc/rfs/english/reference_framework/common_musc_problems.html
• NHS (UK): Meningitis https://www.nhs.uk/conditions/meningitis/
• NHS (UK): Confusion https://www.nhs.uk/symptoms/confusion/
• NHS (UK): Tetanus https://www.nhs.uk/conditions/tetanus/
• NHS (UK): Dental abscess https://www.nhs.uk/conditions/dental-abscess/
• NHS (UK): Deep vein thrombosis https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
• NHS (UK): Pneumonia https://www.nhs.uk/conditions/pneumonia/
• Centre for Health Protection: Malaria https://www.chp.gov.hk/en/healthtopics/content/24/30.html