Life Saving Advice: When Should You Go To The ER?

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By Dr. Andy Wilson, MD FAAEM, Dr. Lon Young, MD FAAEM

Knowing the symptoms that should always been seen in the emergency room can save a life.

“Should I go to the ER?” This is a difficult question almost everyone faces eventually: Which symptoms should lead a patient to the ER?

While it is difficult to say what definitely does need an ER, it is much more difficult to say what doesn’t need an ER.

For example, feeling “weak” can just mean you’re run down from a long day at work, or your evil trainer at the gym is working you too hard, or maybe you’re not getting enough sleep.

However, at other times, weakness is the result of heart conditions (heart attack, arrhythmias, or critical valve disorders), electrolyte imbalances (abnormal sodium, calcium or potassium levels), blood clots in the lungs (pulmonary embolism), or other dangerous and life-threatening disorders. Perhaps a more approachable question is, “What kinds of symptoms should almost always be seen in the ER?”

Chest Pain

Several serious and life-threatening conditions can present with chest pain: Inadequate blood flow to the heart (myocardial infarction or unstable angina), a blood clot in the lungs (pulmonary embolism), a collapsed lung (pneumothorax), fluid collection or irritation around the heart (pericarditis or pericardial effusion), fluid collection around the lungs (pleural effusion or empyema), or an infection in the lungs (pneumonia).

Abdominal Pain

The list of potential disasters that present as abdominal pain is extensive and nearly all are more common in older adults. More than 30 percent of patients over the age of 65 with abdominal pain have a
surgical emergency.

Evaluating abdominal pain almost always requires urgent labs, ultrasounds, or CT scans to identify emergencies such as a ruptured aorta (the large artery in the abdomen), a bowel obstruction (blockage of the intestines), a perforated bowel segment (a tear in the intestines), gallbladder disease, appendicitis, and many others.

Neurologic dysfunction

Weakness or numbness in an arm, leg, or face, or difficulty speaking could represent a cardinal emergency. These symptoms are often the result of a stroke or tumor and require immediate CT scan and treatment not available in a doctor’s office or an urgent care clinic.

Altered mental status

Any departure from normal thought or behavior could be due to very serious emergencies that require the capabilities of an ER and a specially trained Emergency Physician.

Serious trauma

Head injuries (especially if in a patient on blood thinners), extremity injuries (particularly if significantly swollen or deformed or it cannot be used due to pain), animal bites, or lacerations (particularly if contaminated or on the face) all may require rapid, specialized treatment only available in a licensed ER.

Gastrointestinal Bleeding

Vomiting blood or passing blood in your stool can both represent life-threatening emergencies that absolutely require the expertise and capability that can only be provided in an ER.

This list it is nowhere near exhaustive. Always go directly to a licensed emergency room for any symptoms that you are concerned may represent an emergency condition.

Dr. Andy Wilson, MD, FAAEM, and Dr. Lon Young, MD, FAAEM, are managing partners of CapRock ER in College Station and are Board Certified in Emergency Medicine.