The Pixel Watch will vibrate, sound an alarm, and show a message checking on you on screen if it senses a probable fall and your inactivity for around 30 seconds. Tap the “I’m OK” button to dismiss the warning if it wasn’t a serious fall; touch “I fell & need help” if you want it to contact 911. Otherwise, the sound will last roughly a minute and become louder in the closing seconds. If you haven’t replied to the alarm by then, it will automatically contact emergency services, playing them an automated message asking assistance at your location. (You’ll also be able to communicate with the 911 operator via the watch.)
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