When you wake up in the middle of the night with an alarming symptom—maybe it's a high fever or splitting headache—it's hard to know whether to rush to the emergency room or not. You don't want to overact, but you definitely don't want to underreact either. So how do you know when to go to the Emergency Room (ER) or wait until the next morning to go to your doctor? Here are the most common symptoms that you may experience- and that may leave you wondering what to do! 



While you may be used to the occasional headache from stress or one too many drinks, certain types of headaches can be cause for more concern. The three most common—and not dangerous—types of headaches are tension, cluster, and migraines, but there are a few symptoms of headaches that mean it’s more than an average headache. 

  • In general, go to the ER if:
  • The pain is intense and sudden. 
  • Ask yourself "Is it the worst headache of your life? Did it come on suddenly like you were struck by lightning or hit in the head with a hammer?" 
  • These are the two major questions that allow doctors to gage the risk for a potentially deadly cause of headache known as subarachnoid hemorrhage.
  • A headache is also worrisome if it is accompanied by a fever, neck pain, or stiffness and a rash, which could signal meningitis.

Abdominal Pain

From tummy aches to belly bloat, abdominal pain is the number one non-injury reason for adult emergency room visits. Pain can be caused by a number of factors from gas or a pulled muscle to the stomach flu or more serious conditions like appendicitis or urinary tract infections. 

  • In general, go to the ER if: 
    • you're experiencing intense localized pain, especially in the right lower part of your abdomen or your right upper region. 
    • This could mean that there is an issue with your appendix or gallbladder that may require immediate surgery. 
    • Other concerning symptoms are abdominal pain accompanied by an inability to keep down any food or fluids, blood in the stool, or a severe and sudden onset of the pain.

Chest Pain

With heart attacks as the number one killer for both men and women, it's no surprise that sudden chest pain can be scary and is one of the leading causes of emergency room visits for adults. Heart attacks are at the top of the list due to their frequency and potential risk. 

  • In general, go to the ER if:
    • you are experiencing chest pain along with shortness of breath, decreased activity tolerance, sweating, or pain that radiates to the neck, jaw, or arms—especially if your age or family history puts you at a higher risk for heart attacks. 
    • Do not go to a walk-in or urgent care clinic. Most places will ultimately send you to the ER since they don't have the equipment to handle cardiac-related issues.


Infection can run the spectrum from a simple infected skin wound to serious forms such as kidney infections. The vast majority of infections are viral, which means they won't respond to antibiotics and can be treated at home with over-the-counter symptom management until the virus passes. The key then is to look at the severity of the symptoms. The more severe infections are sepsis (infection throughout the body), pneumonia, meningitis, and infections in people who have weakened immune systems.

  • In general, go to the ER if:
    • Symptoms are severe. You want to go to the ER if there are any concerns, such as confusion, lethargy, low blood pressure, or inability to tolerate any oral fluids. These may suggest a more sinister infection or may just need a little emergency room care, such as medications to help with symptom management, fluids, or possibly antibiotics, to turn the corner.

Blood in your stool or urine

Blood shouldn't ever be found in your stool or urine, so even if your symptoms don't require a trip to the ER, it's important to make an appointment with your physician as soon as possible to determine the source and decide on a treatment plan. Blood in the urine is usually caused by some kind of infection such as a urinary tract or kidney infection or kidney stones.  When it comes to stool, it may often benign, but it can be the sign of something very dangerous. The number one cause is hemorrhoids followed by fissures, infections, inflammation, ulcers, or cancer. If you have a little blood with no other symptoms, make an appointment to talk with your doctor. 

  • In general, go to the ER if: 
    • you have blood in your stool or urine with other symptoms such as a fever, rash or fatigue, large amounts of blood, intense pain, or any evidence of a blockage.

Difficulty Breathing

Shortness of breath is one of the most common emergency department presentations. The most common causes are asthma, Chronic Obstructive Pulmonary Disease (COPD) from smoking or infections such as pneumonia. When it comes to shortness of breath, use this rule of thumb: If you can't breathe, get to the ER.

Cuts, Bumps & Falls

Whether it's a knife accident chopping veggies for dinner or a misstep off the deck stairs, many cuts, bumps, and bruises can be handled at home with icing or home first aid kit supplies.

  • In general, head to the ER if: 
    • what's supposed to be on the inside is on the outside, or what's supposed to be on the outside is on the inside. If you can see muscle, tendons, or bone, it requires more than just a BandAid. It's important to get these addressed because you can have many potential secondary complications from infection to loss of function and ischemia [reduced blood flow]. 


While not pleasant, vomiting is a common symptom that can be caused by a number of conditions, most often viral gastroenteritis ("stomach flu") or food poisoning. Usually vomiting can be managed with home care and a check-in with your primary care doctor. 

  • In general, head to the ER if: 
    • there is blood in the vomit, significant stomach pain, or dark green bilious vomit which could suggest bowel obstruction. Another important factor with vomiting is dehydration. If you are unable to keep anything down, you will need to get medication or treatments to help you stay hydrated. Young children can become dehydrated rather quickly, but most healthy adults can go several days before significant dehydration becomes an issue.


Most of the time, a fever means nothing more than an indication that you are ill. It's actually a healthy sign that your body is responding to an infection. The concern then is not with the fever itself, but with what infection is causing the fever. Don't hesitate to treat it with over-the-counter medicines such as ibuprofen. 

  • In general, go to the ER if: 
    • a fever is accompanied by extreme lethargy or there are other symptoms of infection present. Be concerned about fevers in kids with lethargy, fevers in adults with altered mental status, and fevers with headache and neck pain. 

Loss Of Function

Numbness in your legs, slack facial muscles, a loss of bowel control—if a certain body part or body function stops working suddenly or over time, you need to seek care to find out why. 

  • In general, go to the ER: 
    • Immediately! Whether it is due to a trauma or just develops over time, any loss of function requires immediate evaluation. The two most common causes are physical trauma and stroke, both of which are serious and require medical attention. When something is not working, don't try to 'sleep it off'. If it doesn't work, there is a reason and a doctor needs to see if they can diagnose, reverse, or prevent ongoing problems. 

We hope these tips will help you decide when to seek Urgent Care!