when to go to the emergency room

Know When to Go to the Emergency Room

You’re feeling sick but your doctor is booked and the nearest urgent care center is 45 minutes away. There’s always the hospital emergency room, but your symptoms aren’t that bad. Should you just tough it out?

Figuring out how and where to handle an illness isn’t easy. It’s even harder for people with inflammatory types of arthritis, because complications related to the disease and its treatment can be serious, says Uzma Haque, MD, assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore. Here’s what she suggests:

Primary Care Provider or Rheumatologist

Patients on immunosuppressive medications, especially biologics, should understand potential drug side effects. They should be evaluated by one of their doctors if they experience fever or infection. “Patients should be aware of medication side effects and know when to reach out to their rheumatologist,” Dr. Haque says. (Learn more about arthritis drug side effects here.) Other signs to call or visit your doctor:

  • Flu or flu-like symptoms, such as fever, headache and body aches
  • Rash
  • Acute joint pain and swelling not typical of a flare
  • Mouth sores
  • Bruising and easy bleeding
  • Sudden onset of abdominal pain in patients taking tofacitinib (Xeljanz) or tocilizumab (Actemra)

Urgent Care

Can’t get in to see your doctor? Go directly to urgent care if you have these symptoms:

  • High fever with rash
  • Red, hot, swollen joints
  • Severe and sudden abdominal pain
  • A severe, atypical disease flare
  • Sudden spine pain, which may signal a vertebral fracture (Rheumatoid and psoriatic arthritis are risk factors for both osteoporosis and fractures; corticosteroid use raises the risk.)

Emergency Department

The emergency room, or emergency department, is meant for life-threatening events – severe chest pain, stroke, sudden vision loss, uncontrolled bleeding or trauma. Arthritis drugs can cause serious side effects, such as an infusion reaction or a severe infection, that may need emergency treatment. If you experience them, go to the ER or call 911. Call your rheumatologist’s office, too; it’s helpful for your doctor and emergency providers to communicate. Keep in mind the trip will cost you a lot more than a doctor or urgent care visit and the wait can be lengthy, depending on the severity of your emergency, but these symptoms shouldn’t be neglected.

When to Ride It Out

Most health problems aren’t emergencies and may not require medical help. Dr. Haque says patients usually can handle mild arthritis flares by resting and pacing themselves. Colds and allergies aren’t cause for alarm unless they take longer than normal to go away.

Author: Linda Rath

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