When Should You Call 911? 11 Reasons Not to Wait

Since the 1970s, 911 has been an essential lifeline for people in the U.S. Calling 911 for an ambulance can provide faster transport to the hospital than driving yourself. Emergency responders can give you or your loved one the best chance of getting the treatment you need right away.

But, sometimes, it’s difficult to know what a true health emergency is. Some people might want to call 911 to get care in the emergency room (ER) more quickly. 

But Kenneth Studyvin, MD, an ER physician with more than 40 years of experience, said not to call an ambulance for that reason. “Ambulance arrival doesn’t guarantee quick bed placement, and consider there are a limited number of ambulances. Don’t tie one up for convenience,” he said.

So when should you call 911? Here, we’ll discuss some situations in which it makes sense to call 911 rather than trying to get to the emergency department on your own.

1. Sudden collapse

There are many reasons why someone might faint or pass out. Common ones include standing for long periods of time, giving blood, or severe stress. Usually, people recover quickly from a simple fainting spell. 

But other times, a collapse or loss of consciousness is more serious. Here are some red-flag symptoms with sudden collapse that could indicate something more serious: 

• Passing out for more than a few seconds

• Collapsing without warning symptoms or while already sitting down

• Fainting in the middle of exercise, especially if you also have palpitations or irregular breathing

• Chest pain before or after fainting

• Seizure activity during or after a collapse

• Severe headache, confusion, weakness, numbness, or tingling after waking up

Common causes of a sudden collapse that can be life-threatening include:

• Seizure

• Cardiac arrhythmia

• Heart attack

• Stroke

• Pulmonary embolism, or blood clot in the lung vessels

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• 911 vs. 988: The hotline 988 was established specifically for mental health emergencies. Understand the difference between 988 and 911.

2. Severe chest pain

Chest pain can come from many structures in the chest, including the esophagus, muscles, bones, lungs, and the heart. Sharp and momentary pain is usually caused by less serious issues like muscle strain. Even acid reflux can cause chest pain, typically related to food and stomach upset. 

Of course, chest pain can also be more serious. Symptoms that can indicate a dangerous cause of chest pain include:

• Severe, sudden pain that’s different from pain you’ve had in the past

• Pain that persists despite taking prescribed medications, especially in people with known heart disease

• Pain lasting more than 2 minutes and feels like pressure, squeezing, or tightness

• Pain that’s worse with physical activity or stress and gets better with rest

• Chest pain accompanied by trouble breathing, nausea, dizziness, passing out, or sweating

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Some conditions that can cause chest pain and are an emergency are:

• Heart attack

• Pulmonary embolism

• Aortic dissection, a tear in the big blood vessel in the chest

• A sudden collapse of a lung, called a pneumothorax

3. Difficulty breathing

It’s normal to get short of breath during activity, especially if you’re getting more exercise than usual. Other times, having trouble breathing can indicate something more dangerous. Some of the red-flag symptoms that should prompt you to call an ambulance are:

• Very fast breathing that persists for more than a few seconds

• Difficulty speaking in full sentences

• Unusual sounds with breathing (like whistling or wheezing)

• Using extra chest muscles to breathe

• Blue lips, mouth, fingers, or toes

Causes of trouble breathing that are life-threatening include: 

• Sudden worsening of lung conditions like asthma or chronic obstructive pulmonary disease (COPD) that don’t respond to rescue medications

• Pulmonary embolism

• Pleural effusion, or fluid around the lungs

• Pericardial effusion, or fluid around the heart

• Pneumothorax

• Pneumonia  

• Airway obstruction, either from something stuck in the airway or severe inflammation

4. Stroke symptoms

A stroke happens when part of the brain doesn’t get the blood it needs. It’s always a medical emergency, and you should never wait to call for help if you suspect you or a loved one is having a stroke. Signs and symptoms of stroke include:

• New onset weakness or loss of sensation, especially on one side of the body

• New and sudden vision changes

• Sudden trouble walking

• Slurred or difficult speech 

• Becoming suddenly confused

• A severe and sudden headache

There are many possible causes of stroke. These include medical conditions, injury, and medications. What’s important to know is that time is of the essence in a stroke. Even if symptoms go away on their own — which can happen with transient ischemic attacks (TIAs or “mini-strokes”) — don’t wait to get care. 

5. Head and neck injury

Traumatic brain injury is always a medical emergency. If you witness someone with a bad head and/or neck injury, it’s best to wait for medical personnel before helping them move. Moving them the wrong way could do more harm than good. 

Not all head injuries require 911 services. For example, concussions often don’t need intervention. But anyone with a head or neck injury — even minor ones — shouldn’t drive. 

That said, the following symptoms should prompt emergency medical evaluation: 

• Loss of consciousness for several minutes or more

• Bleeding

• Changes in speech

• Limb weakness or numbness

• A severe headache

• Bruising around the eyes

• Severe nausea and vomiting

• Seizures 

A head injury in someone taking blood thinner medications or over the age of 65 should be evaluated right away. Call 911 or take them to the hospital; don’t allow driving in this situation.

6. Severe allergic reactions (anaphylaxis) 

An allergic reaction can be a medical emergency, especially if you’ve had a severe reaction in the past. What’s more, allergic reactions can worsen with each repeated exposure to your allergen. Red-flag symptoms that should prompt you to call 911 are:

• Difficult or noisy breathing

• Swelling of the lips, tongue, or throat

• Blue lips and/or tongue

• A rash, especially one that’s all over your body

• Nausea and vomiting

• Trouble swallowing

• Collapse or passing out

If you’ve had an anaphylactic reaction in the past and have an epinephrine auto-injector (Epipen) at home, use it as soon as you recognize these symptoms. Then get emergency help immediately by calling 911. Even if symptoms improve, they can return quickly. You may need further treatment.

Many things can cause a severe allergic reaction, and the causes are different for everyone. Some of the most common ones are:

• Foods, particularly nuts, shellfish, milk, eggs, wheat, and soy

• Insect stings from bees, wasps, hornets, or fire ants

• Medications, such as antibiotics

• Intravenous contrast dyes used in some imaging tests

• Latex

7. Overdoses

If you suspect you or someone else has taken too much of a substance, it’s crucial to get medical attention. The symptoms will depend on the type of substance ingested. Red-flag symptoms that should cue you to call 911 are:

• Slow or sporadic breathing

• Confusion or decreased consciousness

• Collapse or passing out

• Slow or irregular heartbeat

• Seizures or convulsions

• Slow or slurred speech

• Cold, clammy skin

• Extreme agitation or aggression

An overdose happens when the body’s ability to process the substance is overwhelmed. Some common causes of overdose are:

• Over-the-counter pain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen

• Prescription medications, such as blood pressure medications, antidepressants, and anxiety medications

• Opiates, such as morphine, fentanyl, and oxycodone  

• Alcohol

• Household cleaners, such as bleach, detergents, and ammonia

• Illegal substances, such as cocaine, methamphetamine, hallucinogens, or inhalants

Call poison control If you don’t have any symptoms but are unsure if you should seek care. Trained professionals can help you determine if you need treatment. And they can tell you what symptoms to watch out for and how long you’re at risk after ingestion. 

8. Traumatic injuries

Significant trauma should prompt a call to 911. Many cases are obvious, such as motor vehicle accidents or major fires. Other examples of traumatic injury that’s best handled by emergency responders are:

• Significant bleeding

• Drowning (even after regaining consciousness)

• Broken bones, especially if a bone is protruding through the skin

• Major burns

9. Acute onset, severe headache

Most people have experienced headaches at one point or another. But a severe, sudden headache is different from your typical headache. Call 911 if you or a loved one has a headache that:

• Happens suddenly with no warning symptoms

• Is the worst headache of your life

• Is accompanied by other signs of stroke, like loss of consciousness, confusion, vision changes, or slurred speech

• Causes inability to move or function 

• Starts immediately after trauma or injury

When these worrisome symptoms are present, it could mean the headache is due to something serious. Examples include:

• Stroke

• Brain bleed

• Meningitis, an infection of the fluid around the brain and spinal cord

• Hypertensive crisis, caused by extremely high blood pressure

10. Suicidal or homicidal thoughts

Always call for help anytime someone is having thoughts of hurting themselves or others. You can call 911, but you can also call 988 to reach the Suicide and Crisis Lifeline. This hotline was established specifically for mental crises. There’s someone available 24/7 for confidential support. You can also text HOME to 741-741 to reach the Crisis Text Line. 

11. You can’t safely drive

If you feel that you can’t safely operate a vehicle, don’t drive yourself to the hospital. If you can’t concentrate on the road, you have impaired vision, or you’re in severe pain or distress, have someone else drive you. Remember that emergency responders can provide medical care in an ambulance. So, in the life-threatening emergencies above, it’s always best to call 911. 

If you’re in a rural area or somewhere with heavy traffic, it may take longer for an ambulance to arrive. But a 911 operator can still provide help. They may: 

• Send other first responders who are nearby, like firefighters or police officers

• Direct bystanders in providing first aid until help arrives

• Help you decide if it’s safe to drive your loved one to the hospital in the case of a long ambulance wait time

• Tell you which hospital is closest, especially if you’re in an unfamiliar area

Ride-share and taxi drivers can’t provide care en route and aren’t able to navigate through traffic as quickly and safely as first responders. So, they’re not generally recommended in a life-threatening emergency.

What to expect when you call 911

The first step in getting an ambulance is to dial 911. You can do this from a landline, cellphone, or even some apps. All cellphones can dial 911, even if you don’t have a current plan or don’t have service. But it’s important to note that the operator can’t call you back if you don’t have service. In this case, call back if the call is dropped.

After calling 911, try to stay calm. It’s important to answer as many of the dispatcher’s questions as possible. Expect to give your location and describe the situation. Listen carefully, follow instructions, and don’t hang up until the dispatcher tells you to. They may need more information or give you further instructions. If possible, signal responders when they arrive.

Can I text 911?

Some centers do respond to text messages (text-to-911). Simply type 911 into the number field on your phone. Make sure to include your location and the nature of the emergency. 

To find out if the service is available in your area, call the nonemergency contact number for your local emergency response center. Don’t send a “test” emergency text so you don’t tie up responders. In an emergency, you'll get a bounce-back message if the message doesn’t go through. Even if your center does respond to texts, it’s best to call if you can. 

Why trust our experts?

Written by:

Sarah Studyvin, DO, MPH

Sarah Studyvin, DO, MPH, is training to be an adult congenital heart disease cardiologist. She is a board-certified doctor in internal medicine and pediatrics.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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