This is a direct request that the other person (the frantic one) should state the situation or problem as clearly and simply as possible.
There should be no build-up, background, perspective, etc. Just get to the point. Lay out the difficulty or problem.

What is it that needs this urgent attention?

It is not always easy to state what the problem is. You may focus on the underlying reasons or on the effects, rather than on the situation itself.

Is the problem that the bath in the apartment upstairs is overflowing ? Is it that water is pouring through the ceiling? Is it that the carpet, papers and valuable furniture may be damaged?

If there is something which requires the frantic communication, then that something needs to be spelled out precisely.

If there is a dispute then the fundamental cause of the dispute needs to be spelled out. What exactly is the matter? What are you upset about? What has gone wrong? What is the problem?