Scotland's hospitals are "almost wholly full", with furniture occupancy exceeding 95% past week, the archetypal curate has said.
Nicola Sturgeon said services were facing "truly unprecedented" pressures.
Demand for infirmary beds had been driven up by "extraordinary" levels of wintertime flu, rising rates of Covid infections and cases of Strep A.
Ms Sturgeon said much enactment needed to beryllium done to forestall unnecessary infirmary attendances and to velocity up discharges.
Staffing of the NHS 24 helpline is to beryllium increased, portion wellness boards volition beryllium backed successful maximising capableness by opening GP practices connected Saturdays.
In a peculiar briefing astatine the Scottish government's St Andrew's House headquarters, Ms Sturgeon said this was "almost surely the astir hard wintertime ever for the NHS".
She said the pandemic had dealt a "significant daze to the system" and that this, coupled with "extraordinary levels of different illnesses", was creating unprecedented pressure.
More than 400 radical with Covid-19 were admitted to infirmary past week, connected apical of much than 1,000 patients with wintertime flu for the 2nd week running.
Ms Sturgeon said determination had been much than 100,000 calls to NHS 24 implicit the vacation period, the highest fig successful much than a decade.
Meanwhile the ambulance services responded to much than 16,000 exigency incidents successful the past week, up 11% connected the mean for the erstwhile 4 weeks.
On Wednesday past week, infirmary furniture occupancy exceeded 95% - compared to 87% successful the aforesaid week successful 2020.
Ms Sturgeon said hospitals were presently "almost wholly full" and that much needed to beryllium done to trim "unnecessary attendances".
This volition see an enlargement of the NHS 24 helpline, with an acceleration of enactment connected a caller app and self-help guides.
Ms Sturgeon said services were besides moving connected "other options for patients who bash not request to beryllium astatine mishap and emergency".
The archetypal curate added that much was being done to velocity up the discharge of patients from hospital, with 1,700 radical presently estimated to beryllium stuck successful hospitals.
Extra funds are being fixed to wellness and societal attraction partnerships to publication other attraction location beds, with the extremity of freeing up capableness connected wards.
Health boards volition besides beryllium fixed caller guidance connected the "escalation contingencies" they tin instrumentality to support "critical and life-saving care".
Opposition parties astatine Holyrood person called for the Scottish authorities to instrumentality work for the difficulties facing services.
Both the Conservatives and Labour person demanded the resignation of Health Secretary Humza Yousaf, saying helium "failed to act" connected warnings astir this winter.
However Ms Sturgeon insisted that the wellness caput was "doing a precise bully occupation successful hard circumstances".
Mr Yousaf said helium was "working relentlessly, leaving nary chromatic unturned to marque definite I americium providing arsenic overmuch enactment arsenic I perchance tin to the wellness service".
The archetypal curate besides said that "in a comparative sense, NHS Scotland is dealing with immoderate of these pressures successful a amended mode than we would spot elsewhere and immoderate of the statistic carnivore that out".