Seek Immediate Medical Attention

September 7, 2008 12:51 PM

Is there a common sense guide to symptoms requiring immediate medical attention?

I'm looking for a broad sense of symptoms requiring an immediate visit to an emergency room. Set aside such things as gunshot wounds or javalin impalement; I'm looking for a sense of how bad certain symptoms should be allowed to get before hospitalization becomes absolutely necessary. In terms of pain levels 0-10, particular parts and pieces requiring special rules (fingers, eyes), and excluding situations such as Lion Tamer or Experimental Medication Subject and Pregnancy and the like, I am interested in knowing symptoms that scream (to some) "Go To The Hospital Now."

posted by waraw to health & fitness (22 comments total)

If any of the following happen to me or people I am with, we go to the ER. No questions asked.

1. Unexplained abdominal pain. (Like, it's not something normal for you like heartburn or menstrual cramps.)
2. Abdominal pain that gets worse over the course of several hours.
3. Fainting.
4. Unexplained sudden severe headache.
5. Headache that does not go away after taking pain medication, or gets worse after several hours.
6. Shortness of breath.
7. Chest pain.
8. Difficulty breathing.
9. Changes in vision.
10. Uncontrollable bleeding.

Basically, anything that has the possibility of threatning my life. And in many cases I am going to call an ambulance since they have the stuff on board to assess and stabalize my condition. It's so much better to be safe than sorry.
posted by FergieBelle at 1:24 PM on September 7, 2008 [2 favorites]

NHS Direct Self-Help Guide?
posted by caek at 1:26 PM on September 7, 2008 [1 favorite]

103 fever in an adult is considered redline (not sure for child)
posted by supermedusa at 1:27 PM on September 7, 2008 [1 favorite]

If there is copious fluid coming out of my body for an extended period of time, I get to a doctor.
posted by Foam Pants at 1:38 PM on September 7, 2008

This is slightly more specific, but the book Take Care of Yourself has decision trees (leading to things like "seek immediate medical attention," "make an appointment with your doctor" or "try home remedies") for most ailments.
posted by needs more cowbell at 1:43 PM on September 7, 2008 [1 favorite]

I used WebMD's symptom checker to decide how much I should panic. It tells you what stuff might be, and also tells you when you should freak out and go to emergency.

Ontario also has a handy dial-a-nurse service that does triage by phone.
posted by jacquilynne at 1:47 PM on September 7, 2008

FergieBelle has a pretty good list going. I would add that any chest discomfort (not just pain, but pressure as well) should be checked out.
Also, any change in mental ability (inability to tell what day it is or where you are. Of course this is probably something you would notice in someone else rather than yourself).
Unexplained weakness.
Weakness on one side of the body (including facial droop).
Allergic reactions (itchiness, swelling, redness) that are not localized to the point of entry (ie, if you get stung by a bee on your arm, and you leg starts to swell up).
Any serious irritation to the airway (through inhalation of irritant, or burn).
Blood in stool (either red in color or black and tarry).
Inability to void bladder or bowels for more than a couple days.
Insatiable thirst, hunger and/or need to urinate.
Eye injuries.
Pain greater than 6/10 (on a scale of 0 - 10, with 0 being no pain and 10 being the worst pain you've ever felt). This is, of course, subjective. If you think you need to go to the ED, go.
posted by brevator at 1:52 PM on September 7, 2008 [1 favorite]

Or call 911.
posted by brevator at 1:55 PM on September 7, 2008

Yes. The American Medical Association Series How to Understand your Symptoms (one for Men, one for Women, one for Children). Excellent, easy to read, full of common sense.
posted by nax at 2:05 PM on September 7, 2008 [1 favorite]

very good that they have different symptoms for men v. women. it's only fairly recently understood that women with heart disease/attack have vastly different symptoms than men. ie neck/upper back pain that wont resolve from usual muscle ache/alignment problem treatments. my late step-mother-in-law died after triple bypass surgery for a several years undiagnosed heart problem only manifesting in neck pain/stiffness.

so dont ignore that either!
posted by supermedusa at 2:22 PM on September 7, 2008

Kaiser Permanente gives all new members something they call the Healthwise Handbook, a 100+ page book that for every symptom (eg, dizziness) tells whether you should call them (eg, if accompanied by headache) (not a true example). Maybe you could get your hands on one somehow.
posted by salvia at 3:03 PM on September 7, 2008

Add to the above: sudden, unexplained weight change. I'd say 15 unexplained pounds a week is serious cause for concern. A relative of mine gained 20 pounds in a week and it turned out her kidneys were failing.
posted by sbutler at 3:35 PM on September 7, 2008

Telehealth Ontario (which supermedusa refers to) told me that a temperature of 40.6 C (105 F) means go the the ER immediately.
posted by winston at 3:51 PM on September 7, 2008

I feel like I link to it every week or so here, but I use Where There Is No Doctor (free pdf, though I suggest buying the print copy to have around) to bridge the gap between the short 10-symptom lists above and more general "is this symptom a big deal?" questions.
posted by Forktine at 4:22 PM on September 7, 2008 [7 favorites]

I feel like I link to it every week or so here, but I use Where There Is No Doctor (free pdf, though I suggest buying the print copy to have around)

Wow...that is an awesome pdf!
posted by The Light Fantastic at 10:13 PM on September 7, 2008

Growing up as a doctor's kid meant we never went to the hospital unless a limb was detached. I have friends who are at the other extreme, going to the ER and/or taking their kids for every small stomachache. For me, only #s 2, 8 & 10 on Fergiebelle's list would get me to an ER - the rest would have me call my primary care doctor for advice. You have to find your own comfort level, but the more you know about your own body and how it works and what's normal/abnormal for you, the easier it will be to make those determinations.
posted by judith at 11:01 PM on September 7, 2008

Wow...that is an awesome pdf!

Check out their other books for more awesome at-home health goodness. Where There Is No Dentist is particularly cool, since it explains how to make and use your own dentistry tools. The work the Hesperian Foundation does is really important, so if you can afford it, order the books to go along with the free downloads.
posted by Forktine at 11:11 PM on September 7, 2008 [3 favorites]

re: fergiebelle's list - I have panic attacks occasionally, and some of the symptoms are very similar. Chest pains, stomach pains (everywhere pain really), nausea, headaches. Going to the ER doesn't do much. So check to see if the person's prone to anxiety attacks (though sometimes it can be worth going - it was a string of panic attacks that got me to the hospital and diagnosed with panic disorder in the first place).

Sudden swelling or rashes, or a fever that doesn't go away (or gets worse) are the main things for me. The first due to allergies (that could be dangerous); the second because it could be a flu gone wrong.
posted by divabat at 4:17 AM on September 8, 2008 [1 favorite]

If it hurts so bad you can't sleep all night.
posted by leahwrenn at 10:41 AM on September 8, 2008

I have two different medical home handbooks (one (AMA) from mom, one (Mayo Clinic) from MIL!) -- both have good decision trees for all sorts of symptoms, with recommendations from "suck it up" to "OMG ER now kthkbye!"

Plus you can totally go all hypochondriac reading the rest of the book, with diseases common & bizarre.
posted by epersonae at 9:29 AM on September 10, 2008

Wow, brevator, between my husband and I, we can tick five items off of your list. And let me just say, that entire night after I scratched my cornea was the worst goddamned night of my life. Luckily, me eye is still whole, and my husband did not have a heart attack. Turns out he just should not eat chili rellenos and rocky road ice cream back-to-back.

Also, if I can add to the list of GoToTheHospitalNowOrTemptFate:

-In addition to chest and arm pain, unexplained pain in the jaw. According to my ICU nurse, step-mother, it is the strongest sign of a heart attack.
-If you have a child with sensory disorder (like my neighbor) who falls off a jungle gym and complains of an itchy knee, go the damn hospital. She might have cracked her kneecap, and will likely not mention it again for another month. That Child Services talk is no fun, either.
-Sleepy child and medicine bottle on the floor. This is what they warn you about, for good reason. Even if the kiddo just needs a nap, and somebody dropped the bottle out of their bag, go to the ER.
posted by mitzyjalapeno at 8:50 AM on October 20, 2008

While, "Where there is No Doctor" is helpful - for a person with access to hospitals "Take care of yourself" is much more helpful and has the flowcharts for decision making. I recommend this book for every household, it truly is indispensable.
posted by bigmusic at 8:36 PM on October 20, 2008