4 Signs You Need a Doctor—or the ER

Medically reviewed in December 2020

Let’s face it, stuff happens. You take a tumble from a curb and hit your head. The neighbor’s normally friendly cat bites your child. You suddenly feel a heavy pain in your chest. Often it can be difficult to know what to do. Should you “wait and see?” Call your doctor? Make a beeline to the ER? Here’s your cheat sheet for four common scenarios:

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1. Chest pain
In the ER, we have the mantra that “time is heart muscle” –- meaning that if someone is having a heart attack, the sooner we can open the blocked blood vessel, less the permanent heart damage. That’s why it’s so crucial for people having a heart attack to get to the ER as quickly as possible. But how do you know it’s a heart attack and not just a bad case of acid reflux? One of the commonly described symptoms is chest pressure –- “an elephant is sitting on my chest” is classic, although it can also be a sharp pain or feel like an ache. I start to worry if a patient describes this pressure, especially if it's lasted over five to 10 minutes and is accompanied by shortness of breath, breaking out in a cold sweat, spreading to your arm or back or vomiting. If you have these symptoms, call 911 or go to the ER immediately.

2. Cut with a foreign object in it
I often treat patients who cut their hand on a wine glass that broke while they were doing dishes, a sharp, dirty tool or a kitchen knife slipped, or they had some similar mishap that cut the skin. When this happens, it’s crucial to thoroughly clean the wound and remove all of the foreign material. Otherwise, the cut won’t likely heal optimally -- and it has a high chance of becoming infected. If you’re not sure it’s clean enough or if you know pieces are still inside the skin, a doctor will need to irrigate it and wash out the pieces and bacteria. You may also need stitches if the cut won’t stop bleeding or if the skin gapes apart. An urgent care center may be able to handle this (call before you go) if your regular doctor isn’t available. If they can’t, head to your nearest ER.

3. Dog or cat bite
I love dogs and cats, but their mouths are breeding grounds for bacteria and their bites come with a high chance of infection. Cats are especially a problem because their sharp teeth can deposit bacteria deep into the skin, even if the puncture wound appears to be small. If a cat or a dog has bitten you, you need to see a doctor. The cut needs to be thoroughly irrigated and you’ll likely start antibiotics. You may also need a series of rabies shots if you don’t know if the dog or cat was immunized for rabies.

4. Fall and hit head
After a head injury there are a few symptoms for which you should definitely see a doctor -- and you may even need the ER. Worrisome symptoms include vomiting (especially if it’s at least two or three times); a severe headache that’s the worst you’ve ever had; you have difficulty walking or talking; or you lose consciousness or have trouble staying awake.

If you do need emergency room treatment, use these six tips to make the experience more bearable and -- depending on your condition -- speed you on your way.

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