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Clinical Symptom Guide

When to Wait, Call, or Go to the ER

Common symptoms explained in plain language. Written from a clinical perspective — not a search algorithm.

⚠️ If you think you are having a medical emergency — call 911 now. Do not use this guide in an emergency.

Chest Pain

🚨 Call 911 Immediately

  • Crushing, squeezing, or pressure in the chest
  • Chest pain that spreads to your arm, jaw, neck, or back
  • Chest pain with sweating, nausea, or shortness of breath
  • Any chest pain lasting more than a few minutes

Go to the ER Now

  • Sharp chest pain that gets worse when you breathe or cough
  • Chest pain with a fast or irregular heartbeat
  • Chest pain after a recent injury or fall

Call Your Provider Today

  • Mild chest discomfort that comes and goes
  • Chest pain that feels related to heartburn or acid
  • Chest wall soreness after exercise or coughing

Monitor — May Be Okay to Wait

  • Brief sharp pain that resolves in seconds with no other symptoms
  • Pain clearly related to a known muscle strain

Headache

🚨 Call 911 Immediately

  • Sudden, severe headache — the worst of your life — that came on instantly
  • Headache with confusion, trouble speaking, or face drooping
  • Headache with weakness or numbness on one side of your body
  • Headache after a head injury

Go to the ER Now

  • Headache with stiff neck and fever
  • Headache with vision changes or sensitivity to light
  • Headache that wakes you up from sleep

Call Your Provider Today

  • Headaches that are more frequent or severe than usual
  • New type of headache you have not had before
  • Headache with nausea that is not responding to OTC medication

Monitor — May Be Okay to Wait

  • Typical tension headache with no other symptoms
  • Known migraine following your usual pattern
  • Headache clearly related to dehydration, stress, or lack of sleep

Fever

🚨 Call 911 Immediately

  • Any fever in a baby under 3 months old
  • Fever with stiff neck, rash, or confusion
  • Fever with severe difficulty breathing

Go to the ER Now

  • Fever above 103°F (39.4°C) that is not responding to medication
  • Fever with severe abdominal pain
  • Fever in someone who is immunocompromised

Call Your Provider Today

  • Fever of 101–103°F that has lasted more than 2 days
  • Fever with ear pain, sore throat, or urinary symptoms
  • Fever that keeps returning after going away

Monitor — May Be Okay to Wait

  • Low-grade fever (99–100.9°F) with mild cold symptoms in a healthy adult
  • Fever responding well to acetaminophen or ibuprofen

Stomach Pain

🚨 Call 911 Immediately

  • Sudden severe abdominal pain that is the worst of your life
  • Abdominal pain with vomiting blood or black/tarry stools
  • Rigid, board-like abdomen

Go to the ER Now

  • Severe pain in the lower right abdomen (possible appendicitis)
  • Abdominal pain with high fever
  • Abdominal pain that is getting significantly worse over hours

Call Your Provider Today

  • Persistent abdominal pain lasting more than 24 hours
  • Pain with urinary symptoms (UTI, kidney stone)
  • Nausea and vomiting lasting more than 24 hours

Monitor — May Be Okay to Wait

  • Mild cramping or bloating that comes and goes
  • Stomach discomfort clearly related to something you ate

Breathing Difficulty

🚨 Call 911 Immediately

  • Severe shortness of breath at rest
  • Lips, fingernails, or face turning blue
  • Breathing difficulty with chest pain
  • Cannot speak in full sentences due to breathlessness

Go to the ER Now

  • Shortness of breath that is new and worsening
  • Wheezing that is not responding to your inhaler
  • Difficulty breathing after an allergic reaction

Call Your Provider Today

  • New shortness of breath with activity that was not there before
  • Mild wheezing with a cold or respiratory infection

Monitor — May Be Okay to Wait

  • Shortness of breath clearly from exertion in an otherwise healthy person
  • Mild nasal congestion making breathing slightly difficult

Dizziness

🚨 Call 911 Immediately

  • Dizziness with face drooping, arm weakness, or speech problems (stroke signs)
  • Dizziness with chest pain or irregular heartbeat
  • Sudden severe dizziness with no clear cause

Go to the ER Now

  • Dizziness after a head injury
  • Severe spinning sensation with vomiting that will not stop

Call Your Provider Today

  • Recurring dizziness or lightheadedness
  • Dizziness after starting a new medication
  • Dizziness with hearing changes or ringing in your ears

Monitor — May Be Okay to Wait

  • Brief lightheadedness when standing up quickly (orthostatic)
  • Mild dizziness clearly related to not eating or dehydration

Back Pain

🚨 Call 911 Immediately

  • Back pain with loss of bladder or bowel control
  • Back pain with numbness in the groin or inner thighs
  • Back pain after a major trauma or accident

Go to the ER Now

  • Severe back pain with fever (possible kidney infection or spinal infection)
  • Back pain with significant leg weakness

Call Your Provider Today

  • Back pain with shooting pain, tingling, or numbness down the leg
  • Back pain that has lasted more than 2 weeks with no improvement
  • New back pain in someone over 50

Monitor — May Be Okay to Wait

  • Typical muscle strain back pain after exercise or lifting
  • Mild lower back pain that is improving with rest and OTC pain relievers

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