When to Go to the Emergency Department

If you feel sick, in pain or simply uncomfortable, you probably want to take care of the health issue at the root of it right away. While the reality is most health problems are not emergencies, sometimes you need to head to the emergency department (ED). Emergency doctors are trained to differentiate minor ailments from major ailments and they are trained and equipped to treat all of them.

A medical emergency is often defined as an issue that requires immediate care, a serious illness or injury, or serious symptoms. In other words, you are not going to the ED because it is convenient; you are going because it is necessary.

Here are some symptoms and conditions that most doctors agree should always be treated as emergencies and signal you to get to an ED.

Chest Pain

There are four systems in your body that can trigger chest pain: your heart, lungs, stomach and muscles/ribs. The most common signs of a heart attack include chest pain, chest heaviness, chest pressure and squeezing type of symptoms, jaw discomfort, shoulder pain or discomfort, and pain or discomfort in your back. There are some other symptoms that may not be recognized as those of a heart attack and sometimes the symptoms are not directly in the chest. Some of these include nausea, heartburn and shortness of breath without any chest pain.

Women do not always experience the same “classic” heart attack symptoms as men. Many women report having vague or even “silent” symptoms like stomach pain, lightheadedness, fatigue, and a nervous, cold sweat.

If you are concerned at all or if any of these symptoms are severe, call 911 and go to the ED immediately.

Shortness of Breath

If this symptom comes on suddenly, is accompanied by pain, and you have a history of heart issues, or you have asthma or emphysema, go to the ED. If you experience this symptom after a recent surgery, it could be due to possible blood clots in lungs.

Pneumonia, asthma and COPD are also common conditions that can cause shortness of breath. If you are concerned at all or if any of these symptoms are severe, call 911 and go to the ED immediately.

Weakness and/or Numbness

This symptom could be a sign of a transient ischemic attack (TIA), which is a mini or warning stroke. It is also associated with a major stroke – if you are having a major stroke, this symptom will be accompanied by arm drift, facial droop, garbled speech, vision changes and dizziness.

A stroke can be caused by bleeding in the brain, which would usually be accompanied by a severe headache. A stroke can also be caused by blood clots – with this type of stroke, you likely will not have a headache, but you will have numbness and weakness.

If you think a loved one is having a stroke, think “FAST:”

• Face: Ask your loved one to smile to see if one side of their face droops.
• Arm: Ask them to raise both arms. Check if one of their arms drifts downward.
• Speech: Ask your loved one to speak and say a simple phrase to hear their speech – listen for it to sound slurred or strange.
• Time: If you detect any of these signs, call 911.

Uncontrolled Bleeding

If you sustain an injury that causes nasal, mouth, vaginal, penile or rectal bleeding that you cannot stop, get to your emergency room. Additionally, you should not delay going to an ED if you are coughing up or vomiting blood.

Severe Pain Due to an Injury

If you have back pain that is radiating down your leg along with a loss of bowel or bladder control, get to an emergency room. You should also go to the ED if your pain is accompanied by deformity or a lack of color in your arm or leg.

Headache or Migraine

No, you shouldn’t go to the ED any time you have a headache or a migraine (if you are predisposed to them). You should, however, get to an emergency room if the migraine or headache is new to you, if you’ve never had this type of pain before, if the pain is different or the most severe you have ever experienced, or if the headache or migraine comes on suddenly and is accompanied by vomiting and weakness.

Persistent Fever

Fever in of itself is not a reason to go to the ED. It depends on what symptoms accompany the fever. For example, fever accompanied with a headache may require immediate attention. Fever and a little achy may not require immediate attention. The age of the patient is an important consideration also; a fever in a 10 week old child is different than a fever in a 3 year old child.

If your fever does not respond to fever reducing medication, if you have recently had surgery, have a sudden or severe cough, nausea and vomiting, wounds, or burning during urination, go to the ED.

Remember, it is better to go to the ED and find out it is nothing than not go and have a major complication later.