Emergencies in Tokyo

Good to Know

• Unlike many countries, Japan splits emergency numbers: 110 is police-only, 119 is fire/ambulance, and 118 is the coast guard — there's no single all-purpose number like 911.
• Learning a couple of key Japanese phrases helps a lot when calling: 'kaji desu' for a fire and 'kyūkyū desu' for a medical emergency, since the initial operator will usually speak Japanese first.
• Ambulance transport in Tokyo is free, but any hospital treatment or medication once you arrive will be billed, so travel insurance is worth having.
• Download the 'Safety tips' app before you need it — it works offline for key content and is specifically built for foreign visitors with multilingual disaster alerts and an evacuation guide.
• If you're unsure whether a situation needs an ambulance, #7119 offers phone triage, though it's largely Japanese-only — in a genuine emergency, just call 119 directly.
• For any life-threatening emergency, call 119 (fire/ambulance) — Tokyo Fire Department's dispatch service has English-speaking operators available 24 hours.
• Japan's ER system triages patients into primary (minor), secondary (needs hospitalization), and tertiary (life-threatening) care — so a hospital's 'emergency room' may still turn away non-critical walk-ins and redirect them to daytime clinic hours.
• Hospitals designated as a 救命救急センター (kyūmei kyūkyū center) or the more advanced 高度救命救急センター are the ones ambulances route the most critical trauma, cardiac arrest, and poisoning cases to — this is the closest Japanese equivalent to a US 'Level 1 trauma center'.
• You will very likely be asked to pay upfront at the time of treatment; travel/health insurance is typically reimbursed afterward rather than billed directly, so keep every receipt and itemized statement.
• For non-critical issues, it's worth calling ahead — many hospitals, even large ones, will turn away unannounced non-emergency patients or ask them to return during set outpatient hours.