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.

  • Fever and significant pain (often tender to touch) in the center of the back (over the spine or bony area), especially with numbness down one or both legs. There are many possible causes of fever and back pain — the fever could be due to a common ailment, such as the flu, and back pain due to another cause, such as back strain.
  • 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.

  • Sweet or fruity-smelling breath often accompanied by confusion or disorientation. Sometimes mistaken for alcohol, the smell may be a sign of accumulating chemicals in the blood caused by uncontrolled diabetes. Additional signs of out-of-control diabetes include frequent urination and extreme thirst.
  • 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.

  • Sudden, agonizing headache. There are many causes of headache, including sinus infections, seasonal allergies, dehydration, caffeine withdrawal, eyestrain, lack of sleep and low blood sugar. Take immediate action if you have the “worst headache of your life” that hits suddenly. It may be followed by sleepiness or confusion.
  • 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…

  • Fever, often with a headache and/or muscle pain, within a few weeks of spending time in a wooded area. Sometimes there are pink-to-dusty-red spots (darker on the skin of African Americans) on the palms of the hands and the bottoms of the feet or other body parts. However, this rash often appears later or may not appear at all.
  • 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.

  • Blood in stool or on toilet tissue. The blood may make the stool appear maroon or black. It can originate anywhere from the mouth to the anus.
  • 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.

  • Blood in the urine, without pain. The usual causes of blood in the urine are kidney stones or a bladder or prostate infection, typically accompanied by pain. When there is no discomfort, people sometimes take a “wait and see” approach. Women may think that they are having an irregular period.
  • 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.

  • Yellow tinge to the skin and/or whites of the eyes, often with insomnia, fatigue, loss of appetite and/or generalized itching.
  • 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.

  • Cold fingers that can last for hours or even days after exposure to cold water or air. Lingering coldness in the fingers can be caused by anemia or by Raynaud’s syndrome, in which the small blood vessels that supply blood to the tips of the fingers narrow.
  • 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.