How do I decide to go to the emergency room?

Additionally, if the health issue is new, acute and worrying, seek emergency help. It’s best to call 000 rather than drive to hospital if you experience any of these symptoms. Not only is it safer, sometimes paramedics can start treating you when they arrive.

Associate Professor Paul Middleton, deputy director of emergency medicine at Liverpool Hospital advises children should go to the emergency department (ED) if they are:

• short of breath
• becoming progressively lethargic or drowsy
• aren’t interacting
• not drinking or peeing, particularly in small children
• fitting or have an ongoing fever. A fever is anything above 38 degrees Celsius.

What to do if you aren’t sure

If you have time up your sleeve and are unsure how serious your illness or injury is, a good starting point is healthdirect, which offers an online symptom checker and 24-hour telephone health advice (1800 022 222) with registered nurses. They can advise whether you should see your GP, manage the condition at home, or go to an ED.

“Things like minor allergic reactions, minor injuries to muscles and joints and small household mishaps like cuts and lacerations can generally be managed by GPs,” says Royal Australian College of General Practitioners spokesperson and GP, Dr Abhi Verma.

If a fever, vomiting or pain strikes in the middle of the night, can you wait it out and see how it goes or should you seek urgent medical help? It depends. 

“Adults can by and large replace their fluids, and if fever doesn’t resolve [with paracetamol] they can try a cool washing down, although a temperature of 40 or 41 degrees is dangerous.” says GP Dr Kenneth Moroney.

For children, call healthdirect for advice or see their list of warning signs on vomiting and fever.

In the case of pain, if it’s in waves it may not be as concerning. But constant, severe, worsening pain, and in particular headache or chest pain, calls for a hospital visit, advises Assoc Prof Middleton.

He adds that there are examples of when an ED visit might not be appropriate.

“Emergency departments are there for emergencies; they aren’t there to get in to see a specialist faster, to deal with a chronic health issue you’re fed up with or to get a bit of reassurance.”

“If you [think] it’s an emergency or a potential emergency then that’s fine, however some people use the ED for convenience.”

According to the Australian Institute of Health and Welfare, 9.3% of the 7.8 million emergency department presentations in 2016–17 were for non-urgent conditions.

Options other than the ED

If your health problem isn’t an emergency, but still needs prompt treatment, and you can’t get in to see your GP, consider these options:

The advice is seemingly everywhere—ONLY go to the emergency room for a true emergency. But, how can you know what’s an emergency, and what’s not? We’ve gathered 15 symptoms that are definitely ER worthy and how you can tell. This list of symptoms is not complete, but does cover the most common questions people have when deciding whether to visit an emergency room.

Remember – If you are alone and experiencing emergency symptoms, don’t try to drive yourself to the ER. Call 9-1-1. Ditto if you are alone with a child having symptoms, or if you can’t safely move the patient or drive them.

1. Some Headaches

If you can describe a sudden headache as your “worst headache ever,” call 9-1-1. Of course, that “worst headache ever” could just be your first migraine, but it could also be a sign of bleeding in the brain (aneurysm or stroke). You don’t want to take that risk.

Even non-severe headaches can be a reason to head to the emergency room.

Seek immediate medical attention for any headache:

• After hitting your head
• When it comes with dizziness, vision problems, slurred speech, or loss of balance
• With fever, stiff neck, or vomiting
• If you have been sick recently or are taking medications that suppress your immune system

If you have diagnosed migraines or similar severe headache disorders, go to the ER if the headache feels different than usual or if it isn’t relieved by your normal treatments.

2. Dizziness, 3. Confusion, and/or 4. Clumsiness

Mild dizziness or forgetting where you put your glasses (when they’re on your head) don’t qualify. You can bring those up to your doctor at your next office visit, or go to an urgent care for a quick checkup.

The important words here are SUDDEN and/or SEVERE.

However, if any of these symptoms come on suddenly or are severe, call 9-1-1 or get to an emergency room:

• Clumsiness, loss of balance, or fainting
• Unexplained loss of consciousness
• Difficulty speaking or trouble understanding speech

5. Seizures (Without Previously Diagnosed Epilepsy)

For seizures, better safe than sorry.

Call 9-1-1 or go to the emergency room in the event of a seizure, unless the person has a diagnosed seizure disorder (e.g., epilepsy). For people with such disorders, seizures are not usually a cause for alarm. An action plan can help inform family and friends what to do during a seizure and when it's an emergency. Still, if you witness a seizure and don't know if the person has a seizure disorder, play it safe and call 9-1-1.

6. Head Injury

Sometimes, the most serious symptoms don’t start for hours or days after the injury. Head to the emergency room if you have any of these after a head injury:

Any significant bump to the head should trigger a medical visit.

• Extreme fatigue or sleepiness
• Severe mood swings
• Severe headache or neck/muscle stiffness
• Different size pupils (the black portion of the eye)
• Vomiting
• Dizziness/loss of consciousness
• Inability to move arms or legs
• Seizures
• Ringing in the ears

7. Eye Injuries

Eye injuries can lead to vision loss if not treated promptly.

Head to the emergency room if there is:

• Pain or trouble seeing
• Cuts or tears in the eyelid
• Objects in the eye or under the eyelid that can’t be removed easily
• Blood in the clear part of the eye
• Different pupil sizes or shapes
• One eye not moving as well as the other or sticking out more

8. Fever

For babies under 3 months old, any temperature higher than 100.4°F is cause for an ER visit.

Most fevers don’t require an ER visit, unless they are one of the following:

• Over 104°F in adults
• Accompanied by other severe symptoms (e.g., racing heartbeat, stiff neck, rash, trouble urinating, swollen legs, weakness, fainting, diarrhea, and/or vomiting)
• Not responding to medications like acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®)

9. Chest Pain

Even non-heart attack related chest pain can signal something life threatening.

It may feel more like pressure or squeezing than sharp pain – but any chest pain is worthy of an emergency room visit. Even non-heart attack related chest pain can signal something life threatening, such as a severe lung infection. Severe and sudden chest pain may occur alone or with other symptoms, such as radiating pain to the arm or jaw, sweating, vomiting, or shortness of breath.

10. Difficulty Breathing

People sometimes refer to everything from a mild cough to severe wheezing as a “breathing problem.” To know whether it’s an emergency, consider these questions:

If any of these answers are YES, call 9-1-1 or head to the ER.

• Did it come on suddenly?
• Is it severe?
• Is it accompanied by chest pain, nausea, vomiting, or fainting?
• Does it affect the ability to talk?
• Are the lips or fingertips turning blue?

People with asthma or chronic lung disease may be directed by their physicians to go to the emergency room, if their regular medical/action plan does not improve breathing.

11. Severe Pain

Any sudden and severe pain is a signal to head to the ER.

Sudden and severe pain anywhere in the body is a signal to head to the emergency room. Of most concern is any pain in the abdominal area or starting halfway down the back.

12. Cuts and wounds

All animal bites need ER attention.

Head to the emergency room for any deep cut, especially on the face, eye, or genital area. Also, go to the ER for animal bites and any wound that won’t stop bleeding.

13. Burns

Size, severity, and the type of burn determine when to go to the ER.

Go to the ER if burns:

• Char, blister, or leave open skin
• Are on the hands, face, feet, genitals, or joints
• Cover a large area of skin, even if the burns are mild
• Electric or chemical burns

Also, go to the emergency room if there is any reason to suspect that the person inhaled smoke or fumes.

14. Pregnancy Bleeding

If you are experiencing these symptoms after hours, going to the emergency room will always be your best course of action.

While bleeding or spotting during pregnancy can be scary, it’s also very common and does not always mean miscarriage. The choice to go to the emergency room depends on your OB/GYN and the time of day. Typically, your doctor will ask you to come in to figure out the best course of action based on your medical history.

Pregnant women should always go to the emergency room if any of these occur:

• Abdominal pain accompanied by dizziness
• Unusually heavy bleeding
• Symptoms of shock (such as agitation, confusion, or physical signs of lack of oxygen)

15. Testicular Pain

Since testicles are very sensitive, even a minor injury can cause discomfort.

Pain in one or both of the testicles can have a number of possible causes. Sometimes, pain felt in the testicles is actually a sign of groin or abdominal issues. Other times, pain in the testicle itself is caused from issues with the supporting tube and tissue.

If issues are sudden and severe, this can be a sign of testicular torsion or a twisted testicle. Testicular torsion can cause the body part to lose its blood supply, resulting in loss of the testicle. If you suspect testicular torsion or if testicular pain is accompanied by nausea, fever, chills, or blood in your urine, it’s important to seek medical attention immediately.

Sometimes it’s obvious that a situation is an emergency. But sometimes it’s not. If you think you’re experiencing an emergency call 9-1-1 immediately. Our nurses are also available to answer your questions. Or locate the ER closest to you.

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