Determining If or When You Should Go

Last reviewed: July 2026

What You Need to Know

• Never induce vomiting for poisoning. This page used to say some poisons “must be vomited immediately.” That advice is wrong and it can kill.
• Don’t wait two minutes with chest pain. Don’t wait at all.
• Don’t drive yourself to the ER for anything serious. Ambulances start treatment on the way and get you seen faster.
• Urgent care exists now, and it handles most of what people go to the ER for — faster, and for a fraction of the cost.
• Heart attacks in women often don’t involve chest pain. Neither do many in people with diabetes.

☠️ The Correction: Poisoning

The old version of this page said: “some poisons must be vomited immediately and other poisons must be diluted with water immediately.”

This is dangerous, outdated advice.

Never make someone vomit. Syrup of ipecac was withdrawn from the market after the American Academy of Pediatrics stopped recommending it in 2003. Expert toxicology bodies concluded there is no evidence it improves outcomes — and it causes real harm:

• Corrosive substances burn a second time on the way back up.
• A drowsy or seizing person can inhale the vomit into their lungs.
• It delays the treatments that actually work.

What to do instead

1. Call Poison Control: 1-800-222-1222 — free, confidential, 24/7, staffed by specialists. Or use the webPOISONCONTROL online tool.
2. Call 911 immediately instead if the person collapses, has a seizure, is struggling to breathe, or can’t be woken.
3. Have the container in your hand when you call. They’ll ask what, how much, when.
4. Water or milk — but only in one specific case: if the substance is burning, irritating, or caustic, AND the person is conscious, not convulsing, and able to swallow, give a small amount. Otherwise give nothing until told to.
5. If opioid overdose is possible and naloxone is available — use it. See heroin & opioid withdrawal.

Put 1-800-222-1222 in your phone right now. And on the fridge.

Where to Go: The Three Tiers

The old version of this page offered two options: your doctor, or the ER. That’s not how American healthcare works anymore.

Urgent care handles far more than people realise: sprains, simple fractures, cuts needing stitches, infections, UTIs, flu, mild asthma flares, rashes, minor burns, ear infections. Most have X-ray on site.

Many insurers also run a free 24/7 nurse line. Check your card. It’s the most underused resource in American healthcare — and it’s designed for exactly the question this page is about.

And note: the old claim that “primary care doctors are generally available 24 hours a day” is no longer true for most people. Don’t build a plan around it.

Go to the ER (or Call 911)

Heart attack — and the presentation nobody tells you about

Classic: chest pressure, squeezing, fullness or pain; pain spreading to arm, jaw, neck or back; cold sweat; shortness of breath.

⚠️ But heart attacks in women, people with diabetes, and older adults frequently involve NO chest pain at all. Instead:

• Unusual, overwhelming fatigue
• Nausea or vomiting
• Jaw, neck, upper back, or stomach pain
• Shortness of breath
• Light-headedness
• A vague sense that something is very wrong

Women’s heart attacks are missed and dismissed at a higher rate, partly because both patients and clinicians are looking for the film-version symptom. If something feels badly wrong, say the words “I think I might be having a heart attack.” Say them out loud.

Don’t wait to see if it passes. Call 911. Chew aspirin only if the dispatcher tells you to. See in tune with the beat of your heart and how to relieve chest tightness and shortness of breath — but not while symptoms are happening. Call 911.

Stroke — remember BE-FAST

• Balance — sudden loss of balance or coordination
• Eyes — sudden vision loss or double vision
• Face — one side drooping
• Arms — one arm drifts down when both are raised
• Speech — slurred, garbled, or can’t understand you
• Time — call 911 immediately

Note the time symptoms started — or when the person was last known to be normal. Clot-busting treatment is time-limited, and this single piece of information determines what treatment they can be given.

Time is brain. Every minute of delay costs neurons that don’t come back.

Sepsis — the one this page never mentioned

A leading cause of death in hospitals, and it’s recognizable. Infection plus:

• Confusion or disorientation
• Extreme shivering, or severe muscle pain
• Not passing urine all day
• Severe breathlessness
• “I feel like I might die”
• Skin mottled, discoloured, very pale or blue-ish

Say the word “sepsis” at triage. It changes what happens next.

Anaphylaxis

Give epinephrine first, then call 911. Antihistamines will not save a life. See allergic reactions: what to do in an emergency.

Also the ER

• Loss of consciousness, seizure, or an unwakeable person
• Bleeding that won’t stop with 10 minutes of firm pressure
• Sudden, severe pain — “the worst headache of my life,” or sudden severe abdominal pain
• Serious injury, especially head injury — particularly if on blood thinners
• Vomiting or coughing up blood; black tarry stools
• Broken bone that’s deformed, open, numb, or pale/cold beyond the break
• Fever in a baby under 3 months — go now, no exceptions
• Fever with a stiff neck, confusion, or a rash that doesn’t fade when pressed — possible meningitis
• Suicidal or homicidal thoughts — 988, or the ER. See help for the mind.
• Withdrawal from alcohol or benzodiazepines with shaking, confusion, or seizure — these withdrawals can be fatal. See alcohol dependence and Xanax withdrawal.

Urgent Care Is Usually Enough

• Colds, cough, sore throat, flu, COVID
• Ear infections — see easing your child’s ear infection
• Sprains and probable simple fractures without deformity or numbness
• Cuts needing stitches, where bleeding is controlled
• UTIs
• Rashes, sunburn, minor burns
• Pink eye
• Mild asthma flares — see asthma: help your child breathe easier
• Animal bites once bleeding has stopped — but you likely need rabies and tetanus assessment, so go the same day
• STI testing and treatment — though severe pelvic pain or testicular pain is an ER matter

Fever in an adult, on its own, is usually not an emergency — but fever plus confusion, stiff neck, non-fading rash, severe breathlessness, or no urine output is. See the sepsis section.

Don’t Drive Yourself

This is the instruction the old page never gave, and it matters more than almost anything else on it.

• Ambulance crews start treatment on the way — oxygen, ECG, aspirin, clot-busting protocols initiated before you arrive.
• They alert the hospital, so the stroke or cardiac team is waiting for you.
• You may lose consciousness at the wheel — and then there are two emergencies.
• You will not be triaged faster by walking in. You’ll usually be triaged slower.

Do not drive yourself. Do not let a panicking family member drive you. Call 911.

What to Bring

• Photo ID, insurance card
• A full list of medications and doses — including supplements
• Allergies
• Existing conditions and past surgeries
• Your doctor’s name
• Anything relevant — the pill bottle, the poison container, the thing that stung you
• A person, if you can. Someone who can advocate, remember, and ask questions.

Don’t eat or drink if surgery might be needed.

See before you go to the ER, read this, how to save on your hospital bills, and all hospitals are not created equal.

The Bottom Line

When in doubt about a true emergency, go — and call 911 rather than driving. Nobody has ever been meaningfully harmed by an unnecessary ambulance. People die every day from waiting to see if it passes.

For everything else, urgent care or a nurse line will get you seen faster, cheaper, and often better.

And whatever happens: never, ever make someone vomit.

Related Reading

• Allergic Reactions: What to Do in an Emergency
• CPR Can Make You a Lifesaver
• Before You Go to the ER, Read This
• Getting the Most From Your Doctor
• Do You Know Your Medical Rights?
• The ABCs of Picking a Pediatrician

Sources: Poison Control (poison.org) first-aid guidance and the American Academy of Pediatrics 2003 policy statement on ipecac · Mayo Clinic poisoning first aid · American Heart Association / American Stroke Association guidance on heart attack and stroke recognition · Sepsis Alliance.

This article is for information only. In an emergency, call 911. For poisoning, call 1-800-222-1222.