We studied how emergency operators’ interpretation of callers’ anger, fear, and sadness influenced emergency assessments in 146 authentic emergency calls. All emergency calls need to be decided on quickly and operators discriminated emotional expressions, by separating fear from other emotions across help need levels. Using path analysis and structural equation modeling, caller’s fear, as opposed to expressions of anger and sadness, showed both direct and indirect effects on the intention to provide help. Based on the findings, emergency operators are argued to actively incorporate callers’ expressions into emergency decisions, rather than peripherally processing emotional expression. Such findings allow for a discussion on the interpersonal effects of emotional expressions and, more practically, how fast help will be able to arrive to the location of the emergency.