Neil Shulman, MD
Neil Shulman, MD, is an associate professor of internal medicine at Emory University School of Medicine, and is coauthor of Your Body’s Red Light Warning Signals: Medical Tips That May Save Your Life (Delta).
Some symptoms are signs of a true emergency — but we put off getting prompt medical attention, thinking that if we wait a bit, they will go away. Here, symptoms never to ignore…
The following symptoms can indicate a potential emergency. Call for an ambulance (usually 911). If one is not available, have someone drive you to an emergency room.
Possible danger: There is a possibility of an infection near the spinal column, especially if there is numbness down one or both legs. The back often is tender to the touch, and movement is painful. The infection can spread quickly to the rest of the body, causing a life-threatening emergency.
The emergency room (ER) doctor may order image studies of the back. Other tests may include blood and/or urine cultures and a spinal tap. Antibiotics usually are effective.
Possible danger: A diabetic attack (uncontrolled diabetes) can end in coma and death if untreated.
Important: Victims may smell and act intoxicated (confused and/or disoriented), but it is important to rule out uncontrolled diabetes, rather than assuming intoxication from drugs or alcohol.
In the ER, if your blood test indicates severe diabetes, you will be given an intravenous (IV) drip with fluids, insulin and minerals before being referred for comprehensive diabetic care.
Possible danger: Bleeding in the brain from any of a number of causes, including congenital weakness of a blood vessel, injury to the head or cocaine or amphetamine abuse causing a blood vessel to rupture. At least 20% of people hospitalized with bleeding from a brain aneurysm (a weak point in a blood vessel that swells) die.
Important: Don’t take aspirin — it prevents blood from clotting and may lead to more bleeding.
Usually the ER doctor will order an imaging study of the brain.
The following symptoms usually are not a 911 emergency, but they should be evaluated by a physician as soon as possible…
Possible danger: There is a risk that you have Rocky Mountain spotted fever, which is transmitted to humans by tick bites. It usually occurs between April and September. If untreated, this condition can be fatal.
The doctor will order blood tests to help make a diagnosis. Antibiotics can eliminate the infection.
Possible danger: Blood may come from an open sore in the gastrointestinal (GI) tract, such as an ulcer or a small bulging sac called a diverticulum, but cancer is also a possible cause. Cancer of the GI tract, most often involving the stomach or colon, is potentially fatal.
Important: Even if you have hemorrhoids (swollen and inflamed veins in your anus or lower rectum), the bleeding still could be caused by cancer, so have any bleeding checked.
Possible emergency: Depending on the severity of the bleeding and how long you have been bleeding, this could be an emergency. Also, the elderly and those with other severe illnesses may be especially prone to complications. If you feel dizzy, light-headed or weak, call 911.
If necessary, the doctor will order screening tests. Any growths will be biopsied and examined for cancer.
Possible danger: Cancer of the uterus, kidney, ureter, bladder or prostate, which can be fatal if not treated early.
Important: Do not dismiss bleeding from the vagina as an irregular period or blood from the rectum as hemorrhoids. You may have cancer of the uterus or the GI tract.
A family doctor or internist can determine whether the blood is coming from the vagina, rectum or urinary tract so that you can obtain the appropriate evaluation and care.
Possible danger: A blocked bile duct, due to cancer of the duct, cancer of the pancreas, liver disease, a breakdown of red blood cells or other conditions.
Blood work and an ultrasound (an imaging study) of the liver and bile ducts usually are the first tests.
Possible danger: Raynaud’s can indicate rheumatoid arthritis, lupus or other serious autoimmune disorders. Anemia can indicate cancer and other serious problems. Or you may have serious heart and/or lung problems.
Your doctor will perform an exam and order tests to make a diagnosis.