When to go to the ER: 15 signs and symptoms

The advice is seemingly everywhere — only go to the emergency room for a true emergency. But it’s not always easy to know what that means, especially when a loved one is sick or injured. Here are 15 signs and symptoms that definitely rate a trip to the emergency room. While this list doesn’t cover every potential reason to go to the ER, these are some of the most common reasons people seek emergency medical care.   

If you have any doubt, remember this little rhyme: It's better to go and know than to wait and debate.

 However, you should never drive to the ER if you are:

• Alone and experiencing emergency symptoms
• Alone with a child who’s having emergency symptoms
• Unable to safely move the patient or drive them

Have someone else drive or call 911 in any of these situations. If you think an illness or injury may be life-threatening, always call 911.

1. Some headaches

If you can describe a sudden headache as your “worst headache ever,” call 911. Of course, that “worst headache ever” could just be your first migraine, but it could also be a sign of bleeding in the brain (aneurysm or stroke). You don’t want to take that risk.

Even non-severe headaches can be a reason to head to the emergency room.

Seek immediate medical attention for any headache:

• After hitting your head
• When it comes with dizziness, vision problems, slurred speech, or loss of balance
• With fever, stiff neck, or vomiting
• If you have been sick recently or are taking medications that suppress your immune system

If you have diagnosed migraines or similar severe headache disorders, go to the ER if the headache feels different than usual or if it isn’t relieved by your normal treatments.

2. Dizziness, 3. Confusion, and/or 4. Clumsiness

Mild dizziness or forgetting where you put your glasses (when they’re on your head) don’t qualify. You can bring those up to your doctor at your next office visit, or go to an urgent care clinic for a quick checkup.

The important words to note here are sudden and/or severe.

If any of these symptoms can be described as sudden or severe, call 911 or get to an emergency room:

• Clumsiness, loss of balance or fainting
• Unexplained loss of consciousness
• Difficulty speaking or trouble understanding speech

5. Seizures (without previously diagnosed epilepsy)

For seizures, better safe than sorry.

Call 911 or go to the emergency room in the event of a seizure, unless the person has a diagnosed seizure disorder, such as epilepsy. For people with such disorders, seizures are not usually a cause for alarm. An action plan can help inform family and friends what to do during a seizure and when it's an emergency. Still, if you witness a seizure and don't know if the person has a seizure disorder, play it safe and call 911.

6. Head injury

Sometimes, the most serious symptoms don’t start until hours or even days after the injury. Any significant bump to the head should trigger a medical visit.

Go to the emergency room if you have any of these symptoms after a head injury:

• Extreme fatigue or sleepiness
• Severe mood swings
• Severe headache or neck/muscle stiffness
• Different size pupils (the black portion of the eye)
• Vomiting
• Dizziness/loss of consciousness
• Inability to move arms or legs
• Seizures
• Ringing in the ears

7. Eye injuries

Eye injuries can lead to vision loss if not treated promptly.

Head to the emergency room if there is:

• Pain or trouble seeing
• Cuts or tears in the eyelid
• Objects in the eye or under the eyelid that can’t be removed easily
• Blood in the clear part of the eye
• Different pupil sizes or shapes
• One eye not moving as well as the other or sticking out more

8. Fever

Most fevers don’t require an ER visit. For babies under three months old, any temperature higher than 100.4°F is cause for an ER visit.

Other reasons to visit the ER with a fever:

• Over 104°F in adults
• Accompanied by other severe symptoms (e.g., racing heartbeat, stiff neck, rash, trouble urinating, swollen legs, weakness, fainting, diarrhea, and/or vomiting)
• Not responding to medications like acetaminophen (Tylenol^®) or ibuprofen (Advil^®, Motrin^®)

9. Chest pain

Even chest pain that isn’t related to a heart attack can signal something life threatening, such as a severe lung infection.

It may feel more like pressure or squeezing than sharp pain — but any chest pain is worthy of an emergency room visit. Severe and sudden chest pain may occur alone or with other symptoms, such as radiating pain to the arm or jaw, sweating, vomiting, or shortness of breath.

10. Difficulty breathing

People sometimes refer to everything from a mild cough to severe wheezing as a “breathing problem.” To know whether it’s an emergency, consider these questions:

If any of these answers are yes, call 911 or head to the ER.

• Did it come on suddenly?
• Is it severe?
• Is it accompanied by chest pain, nausea, vomiting or fainting?
• Does it affect the ability to talk?
• Are the lips or fingertips turning blue?

People with asthma or chronic lung disease may be directed by their physicians to go to the emergency room if their regular medical/action plan does not improve breathing.

11. Severe pain

Any sudden and severe pain anywhere in the body is a signal to head to the ER.

Abdominal pain is the number one reason for emergency room visits in the U.S. according to the U.S. Department of Health and Human Services. Of most concern is any pain in the abdominal area or starting halfway down the back.

12. Cuts and wounds

All animal bites need ER attention.

Head to the emergency room for any deep cut, especially on the face, eye or genital area — or for any wound that won’t stop bleeding.

13. Burns

Size, severity, location and the type of burn determine when to go to the ER.

Go to the ER for burns that:

• Char, blister or leave open skin
• Are on the hands, face, feet, genitals or joints
• Cover a large area of skin, even if the burns are mild
• Are electric or chemical burns

Also, go to the emergency room if there is any reason to suspect that the person inhaled smoke or fumes.

14. Pregnancy bleeding

If you are experiencing these symptoms after hours, going to the emergency room will always be your best course of action.

While bleeding or spotting during pregnancy can be scary, it’s also very common and does not always mean miscarriage. The choice to go to the emergency room depends on your OB/GYN and the time of day. Typically, your doctor will ask you to come in to figure out the best course of action based on your medical history.

Pregnant women should always go to the emergency room if any of these occur:

• Abdominal pain accompanied by dizziness
• Unusually heavy bleeding
• Symptoms of shock (such as agitation, confusion or difficulty breathing)

15. Testicular pain

Testicles are very sensitive, so even a minor injury can cause discomfort.

Pain in one or both of the testicles can have a number of possible causes. Sometimes, pain felt in the testicles is actually a sign of groin or abdominal issues. Other times, pain in the testicle itself is caused from issues with the supporting tube and tissue.

If pain is sudden and severe, this can be a sign of testicular torsion or a twisted testicle. Testicular torsion can cause the body part to lose its blood supply, resulting in loss of the testicle. If you suspect testicular torsion or if testicular pain is accompanied by nausea, fever, chills or blood in your urine, it’s important to seek medical attention immediately.

Sometimes it’s obvious that a situation is an emergency. But sometimes it’s not. If you think you’re experiencing a life-threatening emergency, always call 911. Head to the closest ER for illness and injuries that are serious but not life-threatening. And for less severe illness and injuries, our free Ask a Nurse line can help you treat your symptoms at home or refer you to the appropriate care setting.

At Medical City Healthcare, we're dedicated to the care and improvement of human life. So, we hope you'll Take Care!

For more information, call our Ask a Nurse hotline 24/7 or use Find a Doctor online.

Medical City Healthcare provides comprehensive emergency services across North Texas.

You can also get care for minor injuries or illness at one of the many DFW CareNow® Urgent Care locations, with convenient Web Check-In® so you can wait in the comfort of your home.