When to go to an ER

All of us experience changes in our bodies that make us question when should we seek emergency care. The information in these pages provides guidance about some of the most common symptoms and when these symptoms might require a visit to the ER.

If the pain is severe and unrelenting, your abdomen is tender to the touch or the pain radiates to your back, you should immediately visit the closest ER. If the pain is accompanied by any of the following symptoms, you should also seek emergency care:

  • Fever
  • Vomiting blood
  • Dark, black stool
  • Unable to keep food down
  • Experiencing chest pain or having difficulty breathing
  • Irregular heartbeat
  • A feeling of lightheadedness or that you might pass out
  • Individuals who have undergone gastric bypass surgery
  • Individuals who have had a recent endoscopy or abdominal surgery
  • Women who are pregnant or might be pregnant
  • Individuals over 45 experiencing upper abdominal pain

Lower back pain, which can occur anywhere from your rib cage to your buttocks, is often the result of lifting, reaching, twisting and stretching. Upper and middle back pain, in most cases, does get better with time and rest. If your back pain is unrelenting and not relieved by rest, you should immediately visit the closest emergency department. If the pain is accompanied by any of the following symptoms, you should also seek emergency care:

  • Fever
  • Numbness
  • Weakness
  • Bladder or bowel incontinence
  • History of cancer
  • Recent immunosuppression, either from surgery or prescribed drugs
  • Any recent injury or trauma, especially in the elderly
  • Prolonged use of steroids
  • Intravenous drug use

Children are the most common group to be bitten by dogs, cats and other pets. Children are also most at risk of bites from other children. If a bite occurs, emergency care may be necessary in the following situations:

  • Cat bites: Cat bites can easily become infected, especially when they happen on the hand or near a joint. A doctor will typically prescribe antibiotics.
  • Bites in the hand, face or joints: Dog and cat bites to the face, hands or joint tissue can cause underlying damage and infection.
  • Risk of rabies or tetanus: Wild, feral animal bites or bites from livestock carry the risk of rabies and tetanus. Follow-up shots may be necessary.
  • Risk of viral transmission: When human bites break the skin, viruses can be transmitted. It is always a good idea to have a human bite checked by a doctor.

Some snakes, spiders and insects can be very poisonous.

  • Snake bite: Unless you know for sure the snake is not poisonous, seek emergency treatment and be prepared to describe the snake to the emergency staff.
  • Spider bite: If you notice any of the following symptoms, seek emergency care: surrounding redness and warmth, drainage from the bite, severe pain at the bite location or anywhere else in the body, severe cramping or vomiting.

For some people, the sight of blood can be scary, even when it’s not life threatening. So how do you know when bleeding requires a trip to the emergency room?

The short answer is you should go the ER if you are losing a significant amount of blood, and bleeding is not controlled with direct pressure.

If you are unsure whether bleeding is serious enough to go to the ER, follow the guidelines below:

  • Nose: Hold direct pressure on the bridge of the nose for 10 minutes. If bleeding continues for an hour or more, go to the ER.
  • Intestinal: If you are vomiting blood or if there is blood in the stool, go to the ER.
  • Surgical: If you have recently had surgery, and the wound re-opens or starts bleeding, contact your surgeon. He or she may advise you to go to the ER.
  • General: If bleeding is not controlled by direct pressure, visit the ER.
  • Blood thinners: You should go to the ER if you experience bleeding while taking blood thinners. Blood thinners make it harder for your blood to clot on its own, so getting emergency medical help is important.

If the injury seems minor, consider visiting an urgent care facility instead.

Chest pain is any pain – dull, sharp, burning, aching or crushing – experienced from the neck to the abdomen. Sudden chest pain may indicate a serious problem, such as a heart attack or blood clot. Chest pain may also indicate a problem with your lungs, esophagus, muscles, ribs or digestive system. Some of these conditions are life-threatening, and others are not. The only way to know is to seek medical attention.

Symptoms may include:

  • Nausea or dizziness
  • Excessive sweating or ashen color
  • Difficulty breathing/shortness of breath – especially after a long period of inactivity
  • Pain spreading to the jaw, left arm or back
  • Sudden feeling of pressure, squeezing, tightness or crushing under the breastbone
  • Very rapid heartbeat and/or breathing
  • Very low blood pressure or very low heart rate
  • Confusion/disorientation

In short, if you are experiencing chest pain, you should not panic, but you should call 911 or visit the nearest ER.

Coughs and sore throats often seem like par for the course – especially during flu season. But if they are accompanied by any of the symptoms below, or if your immune system is compromised due to an existing condition, you may need to seek emergency treatment.

Seek ER treatment if the cough or sore throat is accompanied by:

  • Difficulty breathing
  • Shortness of breath
  • High fever
  • Coughing up blood
  • Inability to swallow
  • Muffled voice
  • Inability to open mouth all the way
  • Significant swelling on one side of the throat, which may indicate an abscess of the tonsil

Your immune system can be compromised by the following:

  • Cancer
  • Recent transplant (and accompanying transplant medication)
  • Existing severe infection or illness

If you are coughing or have a sore throat while your immune system is compromised, seek emergency care.

Feelings of dizziness can actually indicate two different conditions: lightheadedness and vertigo.

Lightheadedness can cause you to feel dizzy or as if you are about to pass out, but not as though your surroundings are moving. Often, this feeling of lightheadedness goes away once you lie down. Vertigo is a feeling that you or your surroundings are moving when neither actually is. Feeling as though you’re off balance or tilting could be an indicator of vertigo.

If you’re not sure whether your dizziness requires emergency care, consider these guidelines.

If the dizziness is not fleeting, eased by lying down or your balance is compromised, you should immediately visit the closest ER.

If dizziness is accompanied by any of the following symptoms, you should also seek emergency care:

  • Other neurological symptoms, including double vision and loss of vision
  • Slurred speech
  • Weakness in the muscles
  • Difficulty walking
  • Headache
  • Vomiting

Fevers in babies younger than 90 days

If your child is younger than 90 days old, seek emergency care if he or she has a temperature over 100.4 degrees, or if your child’s fever is accompanied by the following symptoms:

  • Vomiting
  • Rash
  • Difficulty breathing
  • Nonstop crying or inconsolable
  • Difficulty waking up to feed

Babies 90 days to 36 months

If your child is 90 days to 36 months old, seek emergency care if he or she has a temperature over 102 degrees for two or more days, or if the fever is accompanied by any of the following symptoms:

  • Does not look well
  • Cannot keep fluids down
  • Burning during urination or does not urinate
  • Rash
  • Difficulty breathing or swallowing
  • Stiff neck
  • Abdominal pain


Seek emergency care if you or a loved one has a fever that lasts for more than two days, or if the fever is accompanied by any of these symptoms:

  • Difficulty breathing
  • Headache
  • Abdominal pain

For the majority of people, the occasional headache shouldn’t cause concern. However, the sudden onset of a prolonged headache may require a visit to the emergency room.

If you experience the sudden onset of a headache that interferes with daily tasks or is debilitating, you should immediately visit the closest ER. If the headache is accompanied by any of the following symptoms, you should also seek emergency care:

  • Difficulty walking
  • Fever
  • Severe pain that begins suddenly
  • Other neurological symptoms, including weakness, numbness, slurred speech and blurred vision

In many cases, a rash or skin irritation does not require emergency care. Common, non-emergency causes may include minor allergic reactions to plants (such as poison ivy and poison oak); allergic reactions to soaps, detergents or shampoos; reactions to heat or cold; and reactions to stress or embarrassment. When rashes occur for these reasons, they generally respond to home care.

However, some rashes can indicate a more serious problem and need emergency care.

Seek ER treatment if the rash is accompanied by any of the following:

  • Fever
  • Joint pain
  • Headache
  • Shortness of breath
  • Tightness/swelling in the throat
  • Areas of tenderness
  • Streaks of red
  • Skin peeling way or blisters in the mouth
  • Abnormal bleeding or bruises under the rash

If the rash is recurring or persistent, it may indicate a skin condition or an ongoing allergic reaction to a medication. You may not need to go to the ER, but you should make an appointment with your primary care physician to seek medical treatment.

You’ve probably experienced feelings of weakness at one time or another, especially when you’re tired, hungry or sick. But when does a feeling of weakness cross the threshold from a condition that can be managed at home to a concern that needs emergency care?

If you’re not sure whether to visit an ER if you’re feeling weak, consider these guidelines.

Weakness in certain areas of the body may indicate a larger, more serious problem. If you are experiencing weakness in the face, or weakness or numbness on one side of the body, you should visit the nearest ER immediately as these signs may indicate that you are having a stroke. Other signs of stroke include:

  • Slurred speech
  • Confusion
  • Drooping in the face

An emergency room visit may also be necessary if you have a feeling of weakness throughout the entire body that is accompanied by these symptoms:

  • Associated fatigue
  • Fever
  • High heart rate
  • Low blood pressure