The paper examines the verbal communication during an emergency, and in particular telephone interaction between the person who calls for help and the operators working in a help centre. Literature in this field (most of it dealing with cases in the USA) inspired by the principles of conversation analysis is reviewed. The paper presents the overall organization of the emergency calls and describes each phase of them. A comparison with ordinary telephone calls allows us to bring into light two particular aspects of the emergency telephone calls, their specialization and the compression of the opening sequence. As a final point it is shown how a misalignment between the parties concerned and a consequent interactional asynchrony can produce serious communication troubles together with real consequences for the involved persons.