24-hour emergency fees in Singapore: A&E vs clinics vs ambulance

Midnight medical emergencies are certainly stressful events – and there’s no telling when you or your loved ones might be caught up in one.

Here’s our guide to what to do and where to go in the event of an unexpected medical emergency.

What to do during a late-night emergency?

First step: Keep calm as much as possible. Whether you or your loved one is experiencing an injured ankle, shortness of breath, stomach pain or so on, keeping your voice and mental state steady will help the whole household remain calm.

If you’re attending to a loved one that’s fallen down or is in a disoriented state of mind, don’t leave them unattended. If they’ve suffered a fall, don’t move them excessively in case the injury gets aggravated.

Your next step will be to assess the symptoms of you or your loved one, before deciding on whether to proceed to the A&E or a 24-hour clinic if you decide that it’s best to immediately seek medical treatment.

A&E vs. 24-hour clinics: Where should I go?

Depending on the nature and severity of the medical condition, as well as the state that the affected individual is in, this will determine if the hospital’s A&E or a 24-hour clinic is the best choice.

Hospital A&Es are typically for legitimately urgent medical conditions – you might find yourself facing longer waiting times if you make a trip to the A&E and there are others on site with more urgent and serious conditions.

Here are some more urgent conditions for which a trip to the A&E is recommended:

• Broken limbs
• Several days of sustained high temperature
• Experiencing breathlessness for a prolonged period
• Sudden and severe pain
• Fits and Seizures
• Vomiting that does not subside
• Blood in your vomit or coughing up blood
• Slurred Speech
• Severe hives
• Injuries experienced by an elderly person
• Suspected concussions
• Severe and/or uncontrolled bleeding

A 24-hour clinic – for injuries and illnesses that don’t require urgent and immediate attention – may be a better choice for:

• Sprained or twisted ankles
• Fever
• Nosebleed
• Cuts and scrapes
• Dizziness
• Headaches and migraines
• Nosebleeds
• Itchy or swollen eyes

When should I call for an ambulance?

In most non-urgent situations, you should be able to make your way to the A&E or the clinic on your own via private-hire cars or with the help of family or friends.

However, it’s likely that you may need to call for an ambulance if:

A person’s condition is potentially life-threatening

This could include symptoms like chest pains, difficulty breathing, sudden confusion and/or an altered mental status. Such symptoms may be signs of a heart attack or stroke, and immediate medical attention may be required.

You are unable to detect breathing or a pulse on someone

And  if they require cardiopulmonary resuscitation (CPR). The dispatcher on the line will be able to assist you on how to perform CPR as the ambulance makes its way to you.

Moving the patient could aggravate the person’s injuries

This is usually seen in falls or motor accidents, where the risk of fractures to the skull and spine are higher and unnecessary movement could make the person’s condition worse.

You are unable to get yourself or the patient to the emergency department

This might be due to fall, injury or weakness, and you are unable to obtain transport at that time.

For people with limited mobility, or who require support equipment such as oxygen and IV drips during transport, they may still have difficulty getting to medical facilities when faced with non-urgent medical conditions.

In such a situation, it may be better to call for a non-emergency ambulance rather than dialing 995, as these emergency services are precious and you don’t want to deplete this life-saving resource.

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What should I ring to the A&E/24-hour clinic?

If you’re preparing to head to the A&E with your loved one, bring their personal identification and if available, photocopies of their medical records, in the case that they have to be admitted and you’ll need to pass them to the emergency personnel.

List of 24-hour clinics and fees in Singapore

List of 24 HR A&E rooms and fees in Singapore

Area	Hospital	Consultation Fee*
Central	KK Women's and Children's Hospital	$120
Central	Tan Tock Seng Hospital	$128
Central	Mt Alvernia Hospital	$96.30 to $127.33
Central	Singapore General Hospital	$121
Central	Farrer Park Hospital	$118 to $123
Central	Raffles Hospital	$100 to $150
Central	Gleneagles Hospital	$160
Central	Mt Elizabeth Hospital	$162
East	Changi General Hospital	$126
East	Parkway East Hospital	$156
West	Ng Teng Fong General Hospital	$120
West	National University Hospital	$121
North	Khoo Teck Puat Hospital	$122

Table taken from MoneySmart

When should I dial 995, and what happens after that?

Once you’ve deemed that an ambulance is required, dial 995 for an SCDF ambulance. The dispatcher will inform you of what to get ready and what to prepare. Answer the dispatcher’s questions as calmly as possible.

Good news: Dialing 995 for an ambulance is free – in the case of a true emergency.

However, if the patient’s status is later assessed as non-emergency by the doctor at the Emergency Department, $274 will be charged for each non-emergency case that the SCDF ferries to the hospital.

Do note that SCDF ambulances will take patients to the nearest hospital so that the patient can receive treatment as soon as possible. You will not be able to choose where the ambulance takes you or your loved one.

Private ambulances

Under the new Healthcare Services Act (HCSA), all private ambulances will be listed as either Emergency Ambulance Service (EAS) and/or Medical Transport Service (MTS).

The former serves as a means to transport patients deemed to be suffering from emergency conditions, while the latter is intended to be used as transport for non-emergency medical situations or for patients who may require monitoring while en-route. You may find the general and detailed fees for Singapore-based EAS and MTS here.

If you find yourself in a situation where you need to call for a non-emergency private ambulance (eg. for loved ones with limited mobility), Homage provides non-emergency ambulance services from $90 per trip by a licensed medical team. Head here to find out more about our private ambulance services.

Waiting time at A&E

Waiting times at the A&E can vary extensively.

A&Es don’t operate on a first-come-first-served basis – if you or your loved one gets classified under the non-emergency patient group, then you can expect a wait time that may stretch to several hours. Most A&Es will have a sign outside to inform patients if the expected waiting time is very long.

So how does this sorting happen? Medical professionals working at the A&E use a process called ‘triage’ to assess and categorise the large number of patients that come into the A&E, so that the groups who need medical attention the most will be able to receive care as early as possible.

Here is an example illustrating Singapore General Hospital’s triage process:

Priority 1: Resuscitation and critically-ill patients

Patients who are in a state of cardiovascular attack or imminent collapse.
Case examples: Heart attack, severe bleeding, asthma attack

Priority 2: Major emergencies

Patients with acute medical conditions and require to be trolley-based and wheeled in for examination and treatment.
Case examples: Major limb fractures, dislocations, severe abdominal pain.

Priority 3: Minor emergencies

Patients with acute symptoms but are in a stable condition and are able to walk on their own.
Case examples: Sprains, minor fractures or dislocations, minor abdominal pain, vomiting, fever, rashes.

Priority 4: Non-emergency

Patients with old and existing conditions or injuries.
Case examples: Chronic joint pains, skin rash, nasal discharge, cataracts, sore throats, etc.

Waiting time at 24-hour clinics

Compared to  the A&E, waiting times at a 24-hour clinic are considerably shorter, with sometimes no wait time at all.

Hence, if it’s not a true medical emergency, visiting a 24-hour clinic would definitely be advisable as the clinic staff would be able to attend to you promptly as long as patient volume is not too high.

Being prepared to deal with an unexpected medical emergency

Unexpected medical emergencies are part and parcel of life, especially as our loved ones get older.

Prevention is better than cure – besides being prepared to deal with emergencies, you may also opt for home care services to ensure that your elderly loved ones are safe and have their needs met around the clock.

This article was first published in Homage.