Emergencies, out-of-hours care and what to do at three in the morning

The worst time to work out how a health system operates is at three in the morning with a sick child. Luxembourg's arrangements are good and they are not obvious: there is a single European emergency number, a small network of hospitals with a rotating emergency service, a set of out-of-hours medical centres for things that are urgent but not emergencies, and a duty pharmacy every night. Twenty minutes spent noting all of it now is the most useful health admin a household can do.

The numbers

• 112 is the European emergency number and reaches the emergency services in Luxembourg: ambulance, fire and rescue. It works from any phone, free, and operators handle several languages.
• 113 is the police number in Luxembourg.
• The poison information service operates through the regional centre and the number is worth having in a household with children.
• Your commune publishes local emergency and duty information.

Put 112 and 113 in every phone in the household, including the children's. It takes a minute.

When to use an emergency department

Luxembourg has a limited number of hospitals and they operate a rotating arrangement for emergency admissions, which means the hospital on duty is not always the nearest one. The duty roster is published, and calling 112 resolves the question if you are unsure.

• Genuine emergencies: chest pain, breathing difficulty, serious injury, loss of consciousness, stroke symptoms, severe bleeding. Call 112.
• Urgent but not emergencies: a fever that will not come down, a suspected fracture, a wound needing stitches, a child who is unwell at the weekend. This is what the out-of-hours arrangements exist for.
• Not for emergency departments: repeat prescriptions, chronic conditions and anything that can wait for a normal appointment.

Out-of-hours medical care

Luxembourg operates a network of out-of-hours medical centres, the Maisons Médicales, covering evenings, nights, weekends and public holidays. They are staffed by general practitioners on a rota and they exist precisely to take pressure off hospital emergency departments.

• They cover the country from a small number of locations, and the opening arrangements differ between weekdays and weekends.
• They work on arrival rather than appointment in general, and waiting times vary.
• Bring the social security card and identification.
• Find your nearest one now and note the address and the hours. It is a five-minute exercise.

For a household with young children this is the single most useful thing on this page. Fevers arrive on Saturday nights.

Pharmacies at night

A rota, the pharmacie de garde, covers nights, Sundays and public holidays. The duty pharmacy is published and rotates between establishments across the country.

• Check the rota before travelling, since the duty pharmacy may not be the nearest one.
• A supplement applies to out-of-hours service.
• Keep a basic home supply: paediatric paracetamol and ibuprofen at the right dose for your children's weights, a thermometer, rehydration sachets, plasters, antiseptic and any regular medication with a margin.

The home supply is what prevents the three in the morning trip. Check it every six months and replace what has expired.

Dental and other emergencies

• Dental emergencies are covered by a duty arrangement at weekends and on holidays, and the information is published alongside the medical rotas.
• Mental health crises are handled through the emergency services and through specific helplines, and the appropriate route depends on the situation. If someone is in immediate danger, call 112.
• Veterinary emergencies operate their own duty rota, which is worth knowing if you have animals.

Information to have written down

Not on a phone that might be lost or dead. On paper, on the fridge, and known to anyone who looks after your children.

• 112 and 113.
• Your address as an emergency service would need it, including the floor, the door code and the building name. This sounds obvious and it is the thing people cannot produce under stress.
• Social security numbers for every family member.
• Your doctor, paediatrician and dentist, with numbers.
• The nearest out-of-hours medical centre.
• Allergies and regular medication for each family member.
• Two emergency contacts, including one who is not in the household.
• Your insurer and any supplementary cover.

Practical points for new arrivals

• Bring your medical records, including vaccination history, when you move. Obtaining them afterwards from another country is far harder.
• Know the active ingredient names of anything you take regularly, because brands differ across borders.
• Register with the CNS and give them your bank details early, so reimbursements can be paid.
• Tell a neighbour where the key is, or leave one with someone. In an emergency this matters more than any app.
• If you live in a building, make sure the entrance code and the apartment number are known to whoever might need to reach you.

Teaching children what to do

In a country where children travel independently early and public transport is free, it is worth spending twenty minutes on this rather than assuming.

• 112, and what to say: where they are, what has happened, and their name. The address matters more than anything else and it is what panic removes first.
• Your full home address, including the floor, the door code and the building, learned by heart.
• A parent's mobile number memorised, not only stored in a phone that may be lost or flat.
• A second trusted adult nearby, and where they live.
• Where the key is, if there is a spare arrangement.
• What to do if they are lost: stay put, find a shop or a bus driver, do not walk further.
• For older children travelling alone, how to reach you if a train or a tram is disrupted.

Write the essentials on a card in the schoolbag as well. It costs nothing and it is the thing that works when a child is too upset to remember anything.

Three questions we are asked

Which hospital do I go to?

The one on emergency duty, which rotates, rather than automatically the nearest. The roster is published and calling 112 settles it. For a planned admission it is a different question and your doctor will direct you.

Will they speak English?

In the emergency services and the hospitals, generally yes, and the 112 operators handle several languages. It is still worth knowing a few key phrases in French, and worth having your medical information written down in French or German.

What does it cost?

Emergency care is covered by the social security system on the usual basis, with the standard reimbursement mechanism applying and hospitals invoicing differently from private practitioners. The cost is not a reason to hesitate in a genuine emergency.

Where this fits

Access to a hospital and an out-of-hours centre is one of the practical differences between living in the capital and living in a village, and it is worth weighing for a household with young children or an elderly parent.

The final decision around where this fits should be explainable in a few sentences.

For when to use an emergency department, note what you can see, what you can measure, what you need to ask and what would be expensive to change.

It is tempting to assume that the numbers is automatically positive, but a serious property guide should also test the opposite case. For the question raised by “The numbers”, the useful detail is not a generic list of advantages.

For out-of-hours medical care, note what you can see, what you can measure, what you need to ask and what would be expensive to change. For the question raised by “The numbers”, the useful detail is not a generic list of advantages.

A stronger reading of the numbers starts by asking what would change for the resident on an ordinary weekday.