Some medical situations present as obvious emergencies requiring immediate attention, such as car accidents, penetrating wounds (like gunshots), noticeably broken limbs, or persistent chest pain. Other conditions may not be instantly recognizable as emergencies. You may be unsure whether to go to a hospital emergency department, drive to Urgent Care, call your family doctor, or wait a few hours to see if symptoms improve.
Deciding Whether To Go To The ER
Some symptoms fall into a “gray zone,” leaving you unsure what to do. These may include:
- Injuries causing pain or swelling when it’s unclear if there’s a major break, a fracture, or internal bleeding
- Head trauma when the person is conscious and acting close to normal
- Burns of varying severity
- Abdominal pain that’s bearable, but intensifying
- An allergic reaction to a bee sting or food that was consumed
- Clammy skin or breaking into a cold sweat
- Feeling weak or lightheaded
- Shortness of breath
- Intense headache
- Seizure
- Pain or numbness in one arm
- Fever
- Vomiting
The problem with many of those symptoms is they can occur for reasons ranging from mild to serious, depending on many factors. At the very least, call your family doctor. Even after hours, most practices have providers on call to answer questions. When in doubt, trust your gut, and if it feels like an emergency, call 911 or get to the hospital emergency room.
Symptoms To Never Ignore
To better understand which symptoms should never be ignored, here’s a breakdown of medical conditions—all of which can potentially lead to death—that require fast, skilled intervention in order to achieve the best outcome.
Heart Attack
Symptoms of heart attack aren’t always obvious. Chest pain can be explained away as a muscle pull or heartburn; whereas heartburn can be symptomatic of a heart attack in women. To be safe, call 911 if a heart attack is suspected. Pay attention to these signs, as noted by the American Heart Association:
- Chest discomfort, typically in the center of the chest, that feels like pressure, squeezing, fullness or pain. This feeling may be prolonged or leave and return
- Discomfort or pain in one or both arms, the back, neck, jaw or stomach
- Shortness of breath, with or without chest discomfort
- Breaking out in a cold sweat, nausea, or lightheadedness
Stroke
A stroke occurs when a blood vessel is blocked, preventing blood flow to the brain, where it’s needed to deliver oxygen to cells. Stroke can also happen when a blood vessel breaks and causes bleeding in the brain. When stroke is recognized and treated quickly, its symptoms can be reversed. Without timely intervention, a person can be left with paralysis, numbness or loss of movement; loss of speech or vision; cognitive difficulties; even death. The best way to recognize symptoms is to think of the acronym: B.E. F.A.S.T. which stands for:
- B — Balance (sudden loss of balance)
- E — Eyes (loss of vision)
- F — Facial drooping
- A — Arm weakness
- S — Speech difficulties
- T — Time is critical (call 911 or get to an emergency room as soon as possible)
Pulmonary Embolism
When a blood clot—usually originating in a deep vein in the leg—travels to the lung, it can block blood flow to an artery in the lung. This is known as a pulmonary embolism and can be fatal. Symptoms may include:
- Shortness of breath
- Chest pain
- Fainting or lightheadedness
- Cough that may include blood
- Rapid or irregular heartbeat
- Excessive sweating or clammy skin
- Leg pain or swelling
- Fever
Anaphylaxis
This severe allergic reaction can occur from allergies to foods like peanuts or shellfish, to bee stings, or from certain vaccines or injections. Many people with severe allergies of this kind have access to epinephrine, or EPI pens, that can reverse symptoms when injected. Even after using an EPI pen, it’s important to call 911 or go to the emergency department, since one injection may not suffice and you could have a delayed reaction. Be alert for signs like shortness of breath, or swelling of the face, tongue, or throat. Also
Other Symptoms You Shouldn’t Ignore
For symptoms with multiple possible causes, stay alert to the potential for serious illness or complications and call your doctor or 911 to ask if you should seek emergency care. These include:
- Severe abdominal pain which could be indicative of appendicitis, bowel obstruction, or diverticulitis (which can lead to intestinal perforation and sepsis)
- Fever (teens and adults) when 103ºF in adults or accompanied by confusion, clammy skin, pain, shortness of breath, jaundice (yellowing of skin or eyes), confusion, stiff neck, or other symptoms could be a sign of sepsis, organ failure, meningitis, or a dangerous infection
- Fever (infants and children) If your newborn is younger than 2 months with a rectal temperature higher than 100.4ºF go to an emergency department immediately. For babies and children 2 months and older, call the doctor.
- Sudden and severe headache may be a sign of aneurysm, brain bleed, or stroke
- Sudden confusion (delirium) could be a sign of stroke or TIA (mini-stroke), an infection such as urinary tract infection (UTI), low blood sugar in someone with diabetes, or a head injury
When in doubt about any of medical symptoms that could indicate an emergency, err on the side of caution. For possible heart attack, stroke, pulmonary embolism, anaphylactic shock, and infant fever, go to the emergency department. For other conditions, either call 911, go to the hospital, or call your primary care provider for guidance. Just don’t ignore what may be serious.
As Lancaster County’s only Level 1 Trauma Center, Penn Medicine Lancaster General Hospital meets the highest criteria for 24/7 emergency care, including direct access to top physicians in every specialty, exceptional surgeons, state-of-the-art technology, and certification by The Joint Commission as an Advanced Primary Stroke Center.