How can I tell if I need to go to the emergency room?

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Alfred D. Sacchetti, MD
Emergency Medicine
You go to the emergency room when you think you have an emergency. What is an emergency for one person may not be an emergency for another, so you can’t make a blanket statement. People like to have a checklist of “if I have this symptom, I should go to the emergency department. If I don’t, I should go to my private doctor or maybe an urgent care center.” You can’t apply that blanketly. It really varies. For example, a mother of five may have a child with a temperature of 102 and feel perfectly comfortable taking care of that child. A mother who’s never had a child before has a newborn with a temperature of 100 and is absolutely apoplectic; she doesn’t know what to do with that child. When you come to an emergency department is really individualized, so you can’t just make that blanket statement. It’s determined by the individual.
 
Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
Go to the emergency room (ER) if your health problem is putting you in immediate danger. Some emergencies are truly life-threatening. That's what the ER is for.

Some of the health problems that need a trip to the emergency room are:
  • breathing in a lot of smoke or swallowing poison
  • broken bone
  • difficulty breathing
  • high fever that doesn’t get better with medicine
  • high fever with a headache and stiff neck
  • overdose of drugs or alcohol
  • seizures
  • severe bleeding or wound
  • sudden weakness on one side of the body
  • suddenly not being able to speak, see or walk
  • suicidal thoughts
  • vomiting or diarrhea that doesn’t stop
When you do arrive to the ER, recognize that you’re in a waiting room with a lot of other emergencies. So, even here, you may have to wait. If you’re truly in danger, a special nurse, called a triage nurse, will likely make the decision to let you skip the line to get help. Healthcare workers recognize signs you don’t. Although you may think another person in the waiting room may not look as sick as you, don't be quick to judge.

This content originally appeared on http://blog.mountainstar.com/
If you have to question whether you should go to the emergency room, that answers the question itself. Watch Lynn Tadlock, RN, of Los Robles Hospital & Medical Center, discusses the circumstances when a patient should contact a health care provider. 
You should go to the emergency room (ER) if you have symptoms so intense that you can't wait for an appointment with your regular healthcare professional or if you have a medical problem that is out of the ordinary. In addition, you should call 911 immediately if you experience any of these conditions:
  • Chest pain or signs of heart attack
  • Open fractures
  • Severe bleeding
  • Head injury or other major trauma
  • Weakness or numbness on one side
  • Loss of consciousness
  • Severe abdominal pain
  • Uncontrolled pain or bleeding
  • Poisoning
 Dr. Kathleen Handal, MD
Emergency Medicine
This is often a tough question that is determined by many factors, such as the type of injury or illness, signs and symptoms and the health history of the person. Hospice patients, for example, shouldn’t be taken to the emergency room (ER) unless directed by their physician or nurse. The ER is where you go when something suddenly happens or changes with your body, it is not where you go when you are dissatisfied with your doctor.

Some common reasons to seek emergency medical care include:
  • change in alertness or mental status, unexplained confusion, loss of consciousness
  • shortness of breath
  • severe headache
  • facial drooping, difficulty speaking or weakness in an arm or leg
  • allergic reaction
  • chest pain
  • bleeding that won’t stop with direct pressure
  • severe wounds
  • major injury, such as head trauma
  • burns (area greater than 1 percent of the body; fingers, toes, genitals, face, neck; third-degree burns)
  • smoke inhalation
  • seizures
  • poisoning
  • severe or worsening reaction to insect bites, medications or foods
  • broken bones
  • coughing or vomiting blood
  • any sudden, severe pain
  • persistent vomiting or diarrhea
  • suicidal or homicidal feelings
  • elevated blood pressure (remember to ask your doctor what is high for you)
Denial kills people! If you’re ever unsure whether or not you’re “sick enough” you can always call your primary care physician first. Describe the symptoms and see what he or she advises. Like the ER, your doctor’s office is a busy place. So have the details of your problem mapped out before you call. The doctor or nurse needs a complete picture of how your body is acting and responding to treatment. If your doctor or his office sends you to the ER, ask that they call ahead and tell them you are coming. Better yet, if you are coming from the medical office, ask them to give you something in writing, since they can get busy and forget to notify of your arrival.

When you’re unsure whether or not to go to the ER, calling your insurance company may also be an option. Many insurance programs provide phone help 24/7. Calling this resource is strongly advised by some insurance carriers and may save you time and money. Some programs even provide medical advice over the phone. Don’t wait until an emergency occurs to investigate this option. Review your insurance program now and determine what resources are available and what numbers to call. The ER will not know what your insurance covers.
It can be hard to know when what's ailing you is cause to call the doctor, and when it's appropriate to go straight to the emergency room (ER). In addition to major traumas and accidents, a number of symptoms could be cause to visit the ER.

Immediately come to the ER if you experience:
  • any symptoms that interrupt your life or your ability to function
  • chest pain
  • severe injury or trauma
  • shortness of breath
  • stroke-like symptoms, including numbness
  • suicidal thoughts
While those symptoms are usually emblematic of a major health concern, other issues may also need emergency care, especially if you don’t have a primary care provider.

They include:
  • abdominal pain, which might be a sign of anything from a urinary tract infection to a perforated ulcer
  • back pain, which can be caused by an injury or come on suddenly
  • bites, especially if you’re not sure what bit you
  • bleeding, whether from your nose, rectum or an injury
  • coughs and sore throats
  • cramping or bleeding while pregnant
  • dizziness or other balance problems
  • fevers, especially if they occur in very young children or elderly people
  • headaches and migraines
  • mood changes
  • rashes and allergic reactions
  • weakness, whether widespread or in a specific part of your body
Babies, young children or elderly people should always be brought to their primary care doctor (or the ER if a primary care physician isn’t immediately available) if they experience any of these symptoms. Even seemingly innocuous problems can turn tragic if left untreated for those age groups.
Phillip Blanc, MD
Emergency Medicine
If you aren't sure if you need to go to the emergency room (ER), remember the acronym URGENT; each letter stands for a symptom to be concerned about. In this video, emergency medicine specialist Phillip Blanc, MD, describes these symptoms in detail.
If you experience any of the following you should go the emergency room:
  • difficulty breathing
  • shortness of breath
  • chest or upper abdominal pain or pressure
  • fainting
  • sudden dizziness, weakness
  • changes in vision
  • confusion or changes in mental status
  • any sudden or severe pain
  • uncontrolled bleeding
  • severe or persistent vomiting or diarrhea
  • coughing or vomiting blood
  • suicidal feelings
  • difficulty speaking
  • unusual abdominal pain
According to the National Center ffor Health Statistics, most emergency departments (EDs) use an acuity scale with three levels or more to evaluate the severity of each patient’s illness or condition. Patients are considered emergent if they have a problem that poses an immediate threat to life or limb. Patients are considered urgent when they require prompt care, but treatment can wait several hours if necessary. Non-urgent patients have conditions that need attention, but time is not a critical factor.

Still, Bernard J. Katz, M.D., of UCLA Health-Santa Monica Bay Physicians, emphasizes that the most important gauge of whether or not to seek emergency medical care, rather than urgent care or primary care, is the patient’s own sense of the seriousness of his or her medical problem.

“If there’s any question, then go to the emergency department,” Bernard J. Katz, M.D., of UCLA Health-Santa Monica Bay Physicians, says. “If you’re uncertain, it’s always better to seek immediate medical care than to wait because problems can become progressively worse, even life-threatening, when treatment is delayed.” Dr. Katz recommends that patients educate themselves about when and where to seek medical care for recurring illnesses and conditions by asking their physicians.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.