When Should I Go to the Emergency Room?

What are the signs that I need to go to the ER?

The emergency room can seem daunting. No one wants to go there unnecessarily, but you should never stay home if something serious is unfolding. Fortunately, there is a practical way to think this through. Let’s do it together.

I want to begin with time frame. Emergencies are usually sudden. If a symptom has been present and unchanged for weeks or months, it is unlikely to be an emergency. The ER is designed for problems that come on quickly and worsen fast. 

Next, consider which bodily function is involved. At the top of the list is breathing. Any new or worsening trouble breathing belongs in the emergency room. The same is true for chest pain, but with an important distinction. Brief discomfort lasting seconds and resolving is usually not an emergency. But chest pain that comes on and gets worse with movement or exertion should be evaluated immediately. Remember that heart attack symptoms can differ in women. While chest pain is the most common heart attack symptom in women, they may also experience less typical symptoms such as pain in their neck, back, jaw or stomach.

Then there are neurological symptoms, particularly those that appear swiftly and persist. Sudden weakness, garbled speech, facial drooping and blurred or loss of vision are classic signs of a stroke. A sudden and severe headache, often described as “the worst headache of my life,” can signal bleeding in the brain and needs immediate care.

Fainting, on the other hand, requires judgment. Most people who faint have warning signs that include feeling sweaty, nauseated or lightheaded, and then they gradually go down. This type of fainting is usually vasovagal, a common reflex when the vagus nerve overreacts to triggers such as stress, pain, even standing for too long. This kind of faint is rarely dangerous, although the American Heart Association recommends that anytime someone faints they should get a physical exam. A more concerning scenario is sudden collapse without warning. One moment you’re standing and talking, the next you’re on the floor. This could be a cardiac event and should be treated as an emergency.

Ask Dr. Adam

Adam B. Rosenbluth, M.D., is an internist and cardiologist in New York City. Each Monday, he’ll weigh in on your questions about how to make your body work better for you. His AARP book will be published in 2027. Join in on the conversation on social media @dradamrosenbluth to learn to move the needle on your personal health in an achievable way.

Email your questions for Dr. Adam to dradam@aarp.org

Intense abdominal pain is another reason to rush to the ER. That’s because abdominal pain is difficult to assess over the phone and often requires imaging. One of the emergency room’s greatest strengths is its ability to do blood tests and scans quickly. Severe tummy pain can signal appendicitis, a gall bladder infection, diverticulitis or an obstructing stone. These are all emergencies.

Vomiting and diarrhea also deserve respect, especially in older adults. Even when the cause is not dangerous, dehydration can become serious quickly. You may need IV fluids.