A fresh call has been made for people to stay away from Wigan Infirmary's A&E department unless they are seriously ill.
Hospital bosses say the unit is again experiencing unprecedented demand for its services.
They are asking people to carefully consider the best place to seek treatment and only go to the A&E department or call 999 if it is a real emergency,
This could be loss of consciousness, severe breathing difficulties, heavy bleeding, severe chest pain, suspected broken bones, deep wounds, swallowing something harmful or poisonous or a drug overdose.
People who attend A&E whose condition is not considered to be serious are warned they could face a wait of more than four hours to see a doctor.
Other sources of help include a GP, pharmacist and NHS 111.
Diane Lee, head of nursing for unscheduled care, said: “Our staff are working tirelessly to do the best for our patients. Unfortunately, unnecessary attendances to our A&E prevent our doctors and nurses from seeing and treating those patients who need urgent care quickly. In addition, this increase in demand is putting a huge strain on the whole hospital.
"With your help and support, we can make sure that we are focusing the right level of attention on our very poorly patients who are suffering serious medical emergencies.”