When to Go to the ER
The hospital emergency room (emergency department), open around the clock for serious injury and illness.
Last revised
Key takeaways
- What it is for: chest pain, trouble breathing, heavy bleeding, loss of consciousness, signs of stroke, severe injury
- Order of treatment: by medical need (triage), not by arrival time
- Most useful single change: Call 911 rather than driving yourself if someone may be having a heart attack or stroke.
- Commonest mistake: Going for prescription refills, work notes or long-standing problems.
- See a doctor if any of the signs under "When to get help" below apply to you.
Why it matters
It is the right place for emergencies and usually the slowest and most expensive place for everything else.
The numbers, in one place
| Measure | Figure |
|---|---|
| What it is for | chest pain, trouble breathing, heavy bleeding, loss of consciousness, signs of stroke, severe injury |
| Order of treatment | by medical need (triage), not by arrival time |
| Your rights | ERs must screen and stabilize anyone with an emergency, regardless of ability to pay |
| Surprise bills | federal law protects you from most surprise out-of-network bills for emergency care |
| Alternatives | your doctor's office, a nurse line, telehealth, urgent care or a pharmacist |
What helps
- Call 911 rather than driving yourself if someone may be having a heart attack or stroke
- For urgent problems that are not life-threatening, call your doctor's office or nurse line first
- Take a list of your medicines, or the bottles themselves, and your insurance card
- Tell the triage nurse clearly what the worst symptom is, not the whole history
What to avoid
- Going for prescription refills, work notes or long-standing problems
- Driving yourself if you feel faint or have chest pain
- Eating or drinking before you have been assessed, in case you need surgery
In depth
The emergency room exists to deal with problems that threaten life, a limb or long-term function, and it is staffed and equipped for exactly that: rapid imaging, labs that run around the clock, specialists on call and the ability to start treatment within minutes. Those resources are what make it the right place in a true emergency and an expensive, slow choice for problems that could wait for a regular appointment or be handled at urgent care.
Patients are seen according to how sick they are, not when they arrived. A triage nurse checks your symptoms and vital signs and assigns a priority. Someone with chest pain, stroke signs or severe bleeding will be taken ahead of a person with a sprained ankle, even if the ankle came first. A long wait usually means the staff think you are stable, and it is a reason to tell them immediately if anything gets worse.
Federal law, known as EMTALA, requires hospitals with emergency departments to provide a medical screening exam and stabilizing treatment to anyone with an emergency condition, whatever their insurance or ability to pay. Billing comes later. The No Surprises Act also limits what insured patients pay for emergency care at an out-of-network hospital. Cost and paperwork should never be the reason you delay going when the symptoms are serious.
Signs and symptoms
- Chest pain, pressure or tightness, especially with sweating, nausea or pain spreading to the arm, jaw or back
- Sudden face drooping, arm or leg weakness, slurred speech, confusion or loss of vision
- Severe trouble breathing, or lips and face turning blue or gray
- Bleeding that will not stop with firm pressure, or a deep wound
- Fainting, a seizure, or someone who cannot be woken
- Sudden severe headache, or severe abdominal pain that does not ease
- Thoughts of harming yourself or others
Causes and risk factors
- Heart attack, stroke and other sudden circulation problems
- Serious injuries from falls, car crashes and sports
- Severe allergic reactions, including swelling of the lips, tongue or throat
- Poisoning or overdose
- Severe infections, especially with confusion, rapid breathing or very low energy
- Complications of pregnancy such as heavy bleeding or severe pain
How it is checked
After triage, you will be registered and then examined by an emergency physician, physician assistant or nurse practitioner. Depending on your symptoms, you may have blood tests, an electrocardiogram (ECG) to check the heart, X-rays, a CT scan or an ultrasound. Results come back at different speeds, which is one reason ER visits often take several hours even when nothing serious is found. Ask what tests are pending and what each one is looking for.
At the end, the team will either admit you to the hospital, place you under observation for further monitoring, transfer you to another facility or send you home. If you go home, you should receive written instructions covering what was found, any new medicines, warning signs to watch for and who to follow up with. Read them before you leave and ask about anything unclear.
Related topics
- Choosing the Right Care: What Published Guidance Supports (Preventive Care)
- Surprise Medical Bills: Sorting the Evidence From the Noise (Health Insurance and Costs)
- Recognizing an Emergency: What Published Guidance Supports (Emergency Care)
- Sexual Health Services: What Published Guidance Supports (Sexual Health)
Where to go next
- When to Go to the ER: Separating Myth From Guidance
- When to Go to the ER: A Beginner-Friendly Start
- Using Health Services: The Complete Guide
- The Evidence on Using a Nurse Line or Urgent Care, Without the Hype
- Having an MRI Scan: What Published Guidance Supports
When to get help
Call 911 immediately for chest pain or pressure, sudden weakness or drooping on one side, difficulty speaking, severe breathlessness, heavy bleeding that will not stop, or someone who is unresponsive. Do not wait to see whether it passes. Follow up with your own doctor after any ER visit.
Where this comes from
- American College of Emergency Physicians — Know When to Go
- MedlinePlus — When to use the emergency room - adult
- CMS — No Surprises Act
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.