Japanese at a Hospital Emergency Room: 119, Night Clinics and Triage

Calling 119 or going yourself

The first decision is whether this is a kyūkyūsha, ambulance, situation or a walk-in one. Chest pain, difficulty breathing, heavy bleeding, a suspected stroke, a bad fall with a head injury, or someone who will not wake up: call 119 at once. The operator will ask whether it is fire or medical, your address, what happened, the person's age and whether they are conscious; many centres can connect an interpreter.

For anything less urgent, such as a cut that needs stitches, a high fever or a sprain, going yourself by taxi is normal and expected. Many regions also run a telephone advice line, dialled with the hash key and 7119 in some cities and a local number in others, where a nurse tells you whether to call an ambulance, go tonight or wait until morning. Look up the number for your city before you need it.

Finding the night and holiday clinic

Regular clinics close in the evening and on holidays, so after-hours care is organised separately. Larger hospitals have a kyūkyū gairai, emergency outpatient department, with its own entrance. Many cities also run a yakan kyūjitsu shinryōjo, a night and holiday clinic, for fevers, colds, minor injuries and children, which keeps the hospitals free for serious cases. The city website or the advice line will tell you which one fits your symptoms.

Phone before you go. The person who answers will ask your symptoms and age and either tell you to come or send you elsewhere. At the door, look for the signs 救急 or 夜間, follow the arrows to the night entrance, and use the intercom if it is locked.

Reception and the insurance card

Inside, the first stop is uketsuke, reception. The clerk will ask for your hokenshō, health insurance card, or the My Number card if you use it for insurance, and whether you have been to that hospital before. If you take regular medicine, hand over your okusuri techō, the pharmacy medicine notebook, or show the packaging on your phone.

Out-of-hours visits often carry an additional charge, and large hospitals may add a fee for patients without a referral letter. The amounts are set by each hospital, so ask at the desk before treatment. You will then be given a clipboard with a form and told where to sit.

The triage questions and how to answer

Before you see a doctor, a nurse carries out toriāji, triage, to decide how urgent you are. The questions come quickly and in a predictable order: what is wrong, when it started, how strong it is, whether it has happened before, and what medicines and allergies you have. Short answers are better than full sentences.

The time question is the one learners struggle with most. Itsu kara means since when, and the answer is a time plus kara: kesa kara, since this morning; ichi-jikan mae kara, since an hour ago; kinō no yoru kara, since last night. For intensity, nurses ask you to rate pain out of ten or ask whether it is getting worse, hidoku natte imasu ka. A number or hai and iie is a complete answer.

Explaining what happened

Once you are with the doctor, you need a short story: what you were doing, what happened and what you feel now. The past tense of a few verbs does most of the work. Korobimashita, I fell; kirimashita, I cut myself; butsukemashita, I hit or bumped it; yakedo shimashita, I burned myself; tabemashita, I ate. Follow with the symptom in the present: ima, itai desu, it hurts now.

Be concrete about the body part and the side. Migi, right, and hidari, left, are easy to mix up when you are in pain, so point as well as speak. If something is broken, bleeding or swollen, the words are oreta kamo shiremasen, it may be broken; chi ga tomarimasen, the bleeding will not stop; harete imasu, it is swollen. Doctors also ask whether you drank alcohol and whether you have a chronic condition, jibyō.

The words on the intake form

The clipboard form is a monshinhyō, a medical questionnaire, and its layout is nearly identical from one hospital to the next. Some hospitals have an English version, but many at night do not, so it is worth recognising the common fields. Write your name as it appears on your passport or residence card.

Yes and no boxes are labelled 有 and 無, or hai and iie, and 該当なし means not applicable. If a question is unclear, leave it and ask the nurse; an honest blank is better than a guessed answer on a medical form.

Waiting, speaking for someone else and leaving

Emergency rooms treat by urgency, so the wait can be long for minor cases. You will be called by name or number, so listen for both. Tests come with a short explanation: kensa, test; saiketsu, blood draw; rentogen, X-ray; CT, read as shī tī.

If you have brought someone else, you become their voice. Introduce the relationship first, then speak in the third person: kanojo wa, she; kare wa, he; musuko wa, my son. Staff will ask what you saw, whether the person has been drinking, whether they hit their head and whether they have a known condition. Answer what you know and say wakarimasen for what you do not.

• Phone before you go; many hospitals cannot take every kind of case at night
• Speak quietly and turn your phone to silent in the waiting area
• Let one person do the talking when you accompany a patient
• Keep your insurance card, medicine notebook and ID together in one pouch
• Say osewa ni narimashita to the staff when you leave, a thank-you for their care
• Collect the receipt and any referral letter; you may need them for insurance or a follow-up

When you are discharged you may be given a shōkaijō, a referral letter, and told to see a clinic in the morning. That daytime visit is covered in the guide to Japanese at the doctor, and the general vocabulary for accidents and disasters is in the emergency phrases guide.

When something goes wrong

The common problems are language, money and being sent elsewhere. If you cannot follow the doctor, ask for an interpreter; availability varies, and a friend on speakerphone is an acceptable substitute. If the bill is more than you can pay tonight, say so at the cashier: hospitals have procedures for paying later.

If the hospital says it cannot treat you, ask where you should go and whether they can phone ahead. Do not leave without a destination. If you were given medicine, check the dosage on the bag before you leave.