Emergency Room Procedures in Tokyo

A Comprehensive Guide for Foreigners

When faced with a medical emergency in a foreign country, even basic procedures can feel overwhelming. For foreign residents and travelers in Tokyo, understanding how emergency medical services operate can make a critical difference in outcomes. This guide walks you through the emergency room (ER) procedures in Tokyo—from calling an ambulance to follow-up care—so that you’re prepared when it matters most.

1. What Constitutes a Medical Emergency?

In Japan, you should go to the emergency room if you experience:

• Chest pain or difficulty breathing

• Serious injuries or fractures

• Heavy bleeding

• Sudden weakness or slurred speech (possible stroke)

• Loss of consciousness

• Severe allergic reactions

• High fever in infants or elderly

• Psychiatric emergencies (self-harm, severe mental distress)

For minor issues like colds or mild pain, visit a clinic or urgent care center instead.

2. Calling an Ambulance in Tokyo

2.1. Emergency Number

Dial 119 for ambulance services. The number is toll-free and available nationwide.

2.2. Language Support

The Tokyo Fire Department offers multilingual support (English, Chinese, Korean, Spanish, Portuguese, Tagalog, etc.) via interpreter services.

If you don’t speak Japanese:

• Say “Help! Emergency. English, please.”

• Provide your location and phone number slowly.

Alternatively, use apps like Japan Travel by Navitime, which includes emergency phrases in Japanese.

3. What Happens When an Ambulance Arrives?

Ambulances in Japan are staffed by trained EMTs. They will:

• Assess your condition

• Provide basic care (oxygen, CPR, IV if needed)

• Transport you to a hospital that has an available ER and is appropriate for your condition

Important: The crew calls hospitals in advance to confirm availability. If the hospital refuses due to overcrowding, they’ll try another.

4. Are Ambulances Free?

Yes. In Japan, ambulance services are free. However, you pay for treatment once at the hospital.

5. Arriving at the Emergency Room

Once at the hospital:

1. You’ll be taken to the ER department for triage.

2. A nurse will assess your condition and prioritize care.

3. You may have to wait if your case is not life-threatening.

6. What Documents Should You Bring?

If possible, bring:

• Health insurance card (NHI or private)

• Residence card or passport

• Medication list or actual medicine

• Allergy information

• Cash or credit card

Even in emergencies, these help speed up admission and treatment.

7. Language Barriers and Support

Most ERs operate primarily in Japanese, but several hospitals in Tokyo offer English-speaking services:

• St. Luke’s International Hospital (Tsukiji)

• Tokyo Medical University Hospital (Shinjuku)

• Juntendo University Hospital (Bunkyo)

• Tokyo Metropolitan Hiroo Hospital (Hiroo)

• Keio University Hospital (Shinanomachi)

Some hospitals offer on-demand interpretation via iPad or phone.

8. Treatment at the ER

You may receive:

• Blood tests, ECG, imaging (CT, MRI, X-ray)

• Medication

• Wound treatment or fracture care

• Emergency surgery, if necessary

• Psychiatric evaluation (via duty psychiatrist)

Doctors will explain findings and recommend treatment. If you need hospitalization, they will admit you or refer you elsewhere.

9. Payment Procedures

9.1. With Insurance (NHI or Shakai Hoken)

You pay 30% of the cost. Most hospitals accept Japanese insurance at the time of billing.

9.2. Without Insurance

You must pay 100% upfront. Be prepared for higher charges, especially if imaging, bloodwork, or surgery is involved.

Typical ER bill:

• Minor treatment: ¥5,000–¥20,000

• Severe case with tests: ¥30,000–¥100,000+

10. Overnight Hospital Admission

If you’re admitted:

• You’ll be asked to present insurance documents

• A deposit may be required (for uninsured patients)

• Rooms vary from multi-bed wards to private rooms (with added cost)

• Meals, pajamas, and toiletries may not be included

Family or embassy staff can help with logistics if needed.

11. Psychiatric or Mental Health Emergencies

In cases of suicidal ideation, panic attacks, or psychosis:

• ER doctors may involve psychiatric specialists

• You may be transferred to a mental health facility

• Involuntary admission is possible under the Mental Health Act (if danger is present)

TELL Lifeline (03-5774-0992) offers 24/7 mental health support in English.

12. Dental and Pediatric Emergencies

• For dental emergencies, each ward designates on-call dentists during off-hours

• Pediatric ERs exist at select hospitals (e.g., National Center for Child Health and Development)

You can check availability via:

• Tokyo Medical Information Service (AMDA)

• Tokyo EMS smartphone app

• Local ward office websites

13. Aftercare and Follow-up

After your ER visit, the hospital may:

• Schedule a follow-up at their outpatient clinic

• Refer you to a specialist

• Provide a written report for insurance or embassy

Always keep your discharge summary and receipts.

14. Using Foreign Insurance

Most Tokyo hospitals operate on a pay-first system. If you have international insurance:

• Ask for a detailed receipt (明細書 / meisai-sho)

• Submit the receipt to your insurer for reimbursement

• Some hospitals accept direct billing for certain expat health plans

15. ER Procedures for Visitors and Tourists

Tourists should:

• Keep their passport and travel insurance card ready

• Know their travel insurer’s emergency number

• Use embassy assistance if necessary

The Japan National Tourism Organization (JNTO) also offers a multilingual tourist helpline at 050-3816-2787.

16. Emergency Services for Non-Japanese Speakers

In addition to hospital resources, foreigners can access:

• TELL Lifeline – Mental health support

• AMDA Medical Information Center – Multilingual hospital directory

• Tokyo Fire Department EMS Interpreters – Phone-based support for 119 calls

• JNTO Emergency Support – For visitors and tourists

17. COVID-19 and Infectious Diseases

During outbreaks:

• Hospitals may limit ER access

• Fever clinics may be set up separately

• Call ahead or consult a ward health center before visiting

Masks and hand sanitation remain standard protocol in most medical facilities.

18. Useful Phrases for the ER

19. Emergency Contact Numbers

• Ambulance / Fire: 119

• Police: 110

• TELL Lifeline (English): 03-5774-0992

• JNTO Emergency Tourist Support: 050-3816-2787

• AMDA Medical Information Center: 03-5285-8088

20. Final Tips

• Keep a medical emergency card in your wallet (with allergies, conditions, contact info)

• Know your blood type

• Carry your insurance card or policy copy at all times

• If in doubt, err on the side of caution and seek care early

Being informed doesn’t prevent emergencies—but it gives you power and peace of mind. Tokyo’s emergency rooms are well-equipped and experienced, and with a bit of preparation, you can navigate them even under pressure.