What to do in a medical emergency in Spain

The number to remember: 112

If you remember only one thing from this article, make it 112. 112 is Spain’s nationwide emergency number. It is free to call from landlines and mobile phones and covers medical emergencies as well as police, fire, rescue and other serious emergencies.

If somebody has collapsed, is unconscious, is having difficulty breathing, has suffered a serious accident, is experiencing a suspected heart attack or stroke, is bleeding heavily or you otherwise believe their life could be in danger, call 112.

You do not need to work out which hospital to drive to. The emergency services will decide what resources are needed and where the patient should be taken.

What about 061?

112 is the general emergency number across Spain, but some autonomous communities also operate 061 for health emergencies. Andalucía is one of them.

The Junta de Andalucía describes 061 as its emergency medical service, operating 24 hours a day, 365 days a year. It can dispatch medical emergency teams when necessary.

However, you do not need to worry about remembering every number used by every autonomous community. If you are in Andalucía and there is a serious medical emergency, just call 112… it’s perfectly appropriate.

In Andalucía, 112 can also provide assistance in several languages, including English.

Emergency or urgent?

Spanish healthcare makes a distinction between an emergencia and an urgencia. An emergency is a situation where somebody’s life may be in danger. Examples include:

• Loss of consciousness

• Cardiac arrest

• Suspected heart attack

• Suspected stroke

• Serious breathing difficulties

• Severe choking

• Major bleeding

• Serious poisoning

• Drowning

• Serious burns

• A major road traffic accident

• Serious injuries following a fall or other accident

These are situations where you should call 112 or, in Andalucía, 061.

An urgent medical problem is something that needs medical attention reasonably quickly but is not considered immediately life-threatening. Fever, pain and vomiting may fall into this category.

For less serious problems, you may be directed towards an appropriate health centre, urgent care facility or hospital emergency department depending on the circumstances.

The important point is simple: If you genuinely think someone’s life may be at risk, treat it as an emergency. Call 112.

Don’t automatically drive to the hospital

If somebody has suffered a potentially life-threatening medical emergency, calling an ambulance is often the safest option. The emergency medical service can begin assessment and treatment before the patient reaches hospital and can decide which hospital is appropriate.

This is particularly important with conditions such as suspected stroke, heart attack, serious trauma, severe breathing problems or loss of consciousness, where time can matter.

If the emergency services tell you to wait for an ambulance, wait for the ambulance.

There are circumstances where somebody with a less serious problem can make their own way to an emergency department. But don’t turn “we’ll just drive them” into the automatic response to every serious medical event.

The mysterious white T-shirt

If you have lived in Spain for a while, you may have heard the old story about putting a white cloth or T-shirt out of the car window when rushing somebody seriously ill to hospital. It sounds like folklore, but it has a basis in Spanish traffic law.

Article 70 of the Reglamento General de Circulación allows a driver of a normal vehicle facing an exceptionally serious emergency, where there is no other option, to signal the situation using hazard lights, intermittent horn signals or a handkerchief or similar visible object.

However, it is not a licence to drive like an lunatic. The driver must still obey the rules of the road, particularly at junctions, and may subsequently have to justify the emergency. These days, the sensible first step is to call 112 and follow the emergency services’ instructions.

But if you ever wondered whether that white T-shirt story was actually true, it was.

What is an emergency department called?

If you need to find a hospital emergency department, look for: Urgencias. You may also see Servicio de Urgencias or Urgencias hospitalarias. These are the words to look for on hospital signs and websites.

And don’t be surprised if the word “emergency” isn’t plastered across the building in enormous English letters. Spain generally assumes you can decipher Urgencias.

Where should you go for a less serious problem?

If you have a medical problem that needs prompt attention but isn’t life-threatening, your options depend on where you live and the autonomous community you are in.

A Centro de Salud is a public health centre providing primary healthcare. Some health centres also have out-of-hours urgent care services.

In Andalucía, urgent care is provided through health centres and hospitals, with different services operating depending on the time and nature of the problem.

Andalucía’s Salud Responde service can also provide healthcare information and access to services on 955 545 060.

Public or private hospital?

This is particularly important for visitors. Spain has an extensive public healthcare system alongside a large private healthcare sector. Some hospitals provide both public and private services from the same building.

If you are entitled to public healthcare, make sure you are being treated through the public system if that is what your entitlement covers.

For visitors using an EHIC, the European Commission specifically warns that some hospitals and health centres provide both public and private treatment. Make it clear that you want state-funded healthcare, or asistencia sanitaria pública. Private treatment is not covered by the EHIC.

What if you are visiting Spain from another European country?

If you are visiting Spain temporarily and are covered by a European statutory healthcare system, you may be entitled to medically necessary state healthcare using your European Health Insurance Card (EHIC).

The EHIC is free and allows eligible people to receive medically necessary, state-provided healthcare during a temporary stay in Spain under the applicable conditions.

However, EHIC does not cover private healthcare, and an EHIC is not a substitute for travel insurance. It does not cover things such as private treatment, repatriation and a number of other costs that travel insurance may cover.

So the sensible combination for a holiday is:

EHIC/GHIC + travel insurance.

Not:

EHIC/GHIC + hope for the best.

What about British visitors?

If you are visiting Spain from the UK, your Global Health Insurance Card (GHIC) or an existing valid EHIC can provide access to medically necessary state healthcare during a temporary stay, subject to the applicable rules. Again, it shouldn’t need to be said, but this applies to state healthcare, not private medical treatment.

If you are travelling to Spain, carry your GHIC/EHIC and make sure you have travel insurance as well.

You can apply for a GHIC card on the NHS website HERE.

What about visitors from the USA?

There is no American equivalent of the EHIC that gives US visitors reciprocal access to Spain’s public healthcare system. If you are visiting Spain from the United States, you should assume that you are responsible for your medical costs and check exactly what your US health insurance covers before travelling.

The US State Department warns that most US health insurance plans are not automatically accepted by doctors and hospitals abroad. Medicare and Medicaid generally do not cover medical treatment overseas, and the US government does not pay medical bills for Americans abroad.

That means travel medical insurance is particularly important for American visitors. Look for a policy that covers emergency medical treatment and, ideally, medical evacuation and repatriation. The US State Department specifically recommends considering travel medical insurance and medical evacuation cover.

Don’t assume that because Spain has a public healthcare system, treatment is automatically free for everyone who happens to be standing in Spain when they become ill, and don’t assume that your American health insurance card will be accepted at the hospital reception desk. Some insurers will arrange direct payment with a hospital; others may require you to pay and then submit a claim. Check your policy before travelling so you know which applies to you.

In an actual emergency, call 112 first. Worry about the paperwork and insurance afterwards.

And what if you live in Spain?

This is different from being a tourist. Obviously! 

If Spain is your habitual country of residence, a GHIC/EHIC is generally not intended to be your normal route into the Spanish healthcare system. So Mrs Briggs who lives on a Costa shouldn’t be using a GHIC when she lives here all year round.

People living in Spain may have public healthcare entitlement through employment, self-employment, pension arrangements, recognised residence and other legal routes. If you are entitled to Spanish public healthcare, you will normally have a Tarjeta Sanitaria Individual (TSI), the individual health card issued through your autonomous community. Your exact entitlement depends on your circumstances.

If you are a pensioner receiving healthcare through another European country’s social security system and live in Spain, an S1 may be relevant. Once properly registered, this can provide access to healthcare in Spain under the applicable rules.

If you live here permanently, make sure you understand your own healthcare entitlement rather than relying on an EHIC/GHIC.

Keep your health information accessible

This is one of those boring jobs that becomes extremely useful when things go wrong. Keep a record of:

• Your full name and date of birth

• Your Spanish health card details

• Your emergency contact

• Allergies

• Current medication

• Important medical conditions

• Previous significant operations

• Your GP or health centre

• Private health insurance details, if applicable

• EHIC/GHIC details if you are visiting Spain

• Your passport or ID details

• Your insurance company’s emergency telephone number

A note on your phone is useful, but remember that an unconscious person cannot unlock their phone. Make sure important emergency information can be accessed through your phone’s emergency-information facility.

If you take regular medication, keeping the names and doses written down can be particularly helpful.

Useful Spanish phrases at Urgencias

You don’t need fluent Spanish to deal with a medical emergency usually, but a few phrases can make things considerably easier.

Necesitamos una ambulancia – We need an ambulance.

Es una emergencia – It’s an emergency.

¿Dónde están las Urgencias? – Where is the emergency department?

Tiene dolor en el pecho – He/she has chest pain.

No puede respirar – He/she can’t breathe.

No respira – He/she isn’t breathing.

Está inconsciente – He/she is unconscious.

Está sangrando mucho – He/she is bleeding heavily.

Ha tenido un accidente – He/she has had an accident.

Se ha caído – He/she has fallen.

Ha perdido el conocimiento – He/she has lost consciousness.

Es alérgico/a a…  He/she is allergic to…

Soy alérgico/a a… – I am allergic to…

Toma estos medicamentos – He/she takes these medicines.

Estoy tomando este medicamento – I am taking this medication.

Me duele aquí – It hurts here (while pointing at the area of course).

Me duele mucho – It hurts a lot.

¿Cuánto tiempo tengo que esperar? – How long do I have to wait?

¿Necesito pedir cita?  Do I need to make an appointment?

¿Puede hablar más despacio, por favor? – Could you speak more slowly, please?

No hablo mucho español – I don’t speak much Spanish.

And one particularly useful phrase:

¿Puede escribirlo, por favor? – Could you write it down, please?

If you’re struggling to understand a medication name, dosage or instruction, having it written down can be much easier than trying to decipher rapidly delivered Spanish while you’re tired, frightened or feeling decidedly unwell.

What should you take to the hospital?

If there is time to do so safely, take:

• Your health card or other proof of healthcare entitlement

• Passport, DNI or other identification

• A list of medications

• Information about allergies

• Details of relevant medical conditions

• Your emergency contact details

• Private health insurance details, if relevant

• EHIC/GHIC details if applicable

• Glasses or hearing aids if you need them

• Phone and charger

But don’t spend 20 minutes packing a suitcase while somebody is having a heart attack. If it is a genuine emergency, call 112 first. Paperwork can wait.

What if you don’t speak Spanish?

Don’t let lack of Spanish stop you calling 112. In Andalucía, the emergency service can provide assistance in several languages, including English. Other areas may differ, but don’t worry… they’ll help. When you call, concentrate on communicating the essentials:

• Where you are.
• What has happened.
• How many people are involved.
• What condition they are in.

If you have someone nearby who speaks Spanish, get them to help, but don’t delay calling while you search for your bilingual neighbour.

What if you are somewhere remote?

This is particularly relevant to people living in rural Spain. Giving an ambulance the name of your village may not be enough. If your house is down a track with no street number, make sure you can explain exactly how to reach it. Ensure that you know:

• The name of your nearest main road

• Which turning leads to your property

• The name of your camino, finca or cortijo if it has one

• A nearby landmark

• The nearest recognisable building

• Which entrance emergency vehicles should use

• Whether a large vehicle can actually reach the property

If you live somewhere difficult to find, keep the location details written somewhere obvious. And if you have a gate that requires a remote control, key or electronic code, think about how emergency crews would get through it. An ambulance arriving at the correct postcode only to discover a locked gate is not particularly helpful.

Should you drive yourself if you think you’re having a heart attack?

Again – it shouldn’t need to be said… but no! If you are experiencing symptoms that could indicate a heart attack, stroke or another serious medical emergency, call 112. Do not decide that you will “just pop down to Urgencias”.

Do not drive yourself. Do not ask your equally panicked spouse to drive while you sit beside them Googling your symptoms. Call the emergency services and follow their instructions.

What happens when you arrive at Urgencias?

At a hospital emergency department, you will normally be assessed according to the urgency of your condition. This process is commonly referred to as triaje. This means that the person who arrived before you may not necessarily be seen before you.

If someone is having a heart attack, for example, they are going to be prioritised over somebody with a painful but non-life-threatening problem, even if the second person has been sitting in the waiting room longer. That is the whole point of triage. However, if your condition changes while you are waiting, tell the staff.

Don’t leave without understanding what happened

Before leaving hospital, make sure you know:

• What the doctors think is wrong

• What treatment you have received

• What medication you have been given

• What medication you need to take afterwards

• How often you need to take it

• Whether you need a follow-up appointment

• Whether you need to return if symptoms worsen

• Which symptoms should send you straight back to Urgencias

Ask for copies of relevant medical reports and test results where appropriate, and if you are given a hospital discharge report, keep it. Having a written record can be extremely useful when you subsequently see your Centro de Salud or a specialist.

What about private health insurance?

If you have private health insurance in Spain, keep the company’s emergency number readily available. Your insurer may have a network of hospitals and clinics and may have specific procedures for authorisation. However, in a genuine life-threatening emergency, do not waste time phoning the insurer before calling 112.

Emergency treatment comes first.

Once the immediate crisis has been dealt with, the insurer can sort out the administrative side. Also remember that having private insurance does not necessarily mean that every medical facility is part of your insurer’s network. Check the policy before you need it.

A little preparation can make a big difference

Nobody expects you to become an amateur paramedic, but there are a few things worth doing now, while everyone is healthy and nobody is panicking.

• Put 112 in your phone.
• If you live in Andalucía, save 061 as well.
• Make sure you know where your nearest public hospital with an emergency department is.
• Find out which Centro de Salud you belong to.
• Keep your health card and identification somewhere sensible.
• If you are a visitor, carry your EHIC/GHIC and travel insurance details.
• If you have private medical insurance, save the emergency number.
• If you live in the campo, make sure you know how you would describe your location to an ambulance.

And learn how to say: “Necesitamos una ambulancia.” You may never need it but, if you do, you will be very glad you know it.

What to do in a medical emergency in Spain: The short version

• If you remember nothing else, remember this: Someone’s life may be in danger? Call 112.
• In Andalucía, 061 is also the emergency medical number.
• Don’t drive someone with a serious medical emergency to hospital unless the emergency services tell you to.
• For less serious urgent problems, contact your local health service or go to an appropriate Urgencias service.
• If you are visiting Spain from Europe, carry your EHIC/GHIC and travel insurance.
• If you are visiting from the USA, don’t assume your American health insurance will cover you. Check your policy and consider travel medical and evacuation insurance before you travel.
• If you live in Spain, make sure you understand your own healthcare entitlement and carry your Spanish health card.
• And perhaps the most useful piece of preparation of all: Know where you are.
  It sounds obvious. It isn’t when you are standing beside a remote finca at two in the morning trying to explain to an operator which of the seventeen dirt tracks you accidentally took.

A few minutes spent preparing now could save a lot of confusion when you really don’t have time for it.