The short list: when it can wait, when to go

The page to keep. Every chapter of the book ends the same way: what it usually is, what to check, when to worry, when to see a human. This is that last part on its own, so you can find it in a hurry.

This is the page to keep. Every chapter in this book has the same spine: what it usually is, what to check, when to worry, when to see a human. This chapter is that last part on its own, so you can find it in a hurry.

One thing first. The line between "this can wait" and "go now" is not how bad it feels. People walk into an emergency department with a broken wrist and sit at home with a heart attack, because a heart attack can feel like indigestion and a wrist is impossible to ignore. Severity of feeling is a poor guide. The specific signs below are a better one.

Go now (call your emergency number, or get to an emergency department)

• Chest pain or pressure, especially with breathlessness, sweating, nausea, or pain spreading to the arm, neck or jaw. Do not drive yourself.
• Breathlessness at rest, or on stairs you used to manage easily.
• Stroke signs: face drooping on one side, arm weakness, slurred or jumbled speech. Time matters more than anything else here.
• Bleeding that will not stop with steady pressure.
• A sudden, severe headache, the worst of your life, especially with a stiff neck, a rash that does not fade when you press it, or confusion.
• Fainting, a seizure, or new confusion.
• A fever in a baby under three months old.
• A limb that is bent wrong, or cold, pale and numb after an injury.
• Trouble breathing or swallowing, or swelling of the lips, tongue or throat.

Today (urgent care, a walk-in, or a call to your doctor)

• A fever that comes back after it had settled. That can be a second infection.
• A wound, or an area of skin, that is spreading red, hot and tender.
• A cough bringing up blood, in any amount.
• Burning when you pass urine with fever, or pain in your back or side.
• Abdominal pain that starts vague and settles into one spot, especially the lower right.
• A new kind of headache, or the first bad one after fifty.
• A rash or swelling that appeared after a new medicine.
• Vomiting that will not stop, or signs of dehydration.

Within a few days (book an appointment)

• Anything from this book that is not improving after three weeks.
• A cough past eight weeks, full stop.
• A lump anywhere new, or a mole changing size, shape or colour.
• Weight loss you did not intend.
• Symptoms that keep coming back in the same pattern.

Can usually wait (self-care, and watch)

• The post-viral cough that is slowly easing.
• The first-step heel pain of plantar fasciitis, if it is not getting worse.
• An ordinary cold, a tension headache, mild heartburn, a passing sore throat.
• A bruise or a minor sprain, if you can use the limb and the swelling is settling.

Two things people get wrong, and both cost. The first is waiting because it is not that bad, when one of the specific signs above is there. The second is going to an emergency department for something a clinic could handle. That is not a sin, but if you are unsure, say what you are unsure about. "I do not know if this is my heart or my stomach" is a perfectly good sentence to open with.

When to see a human

• When any line above says go now or today, that is the answer. Do not wait for a page to convince you.
• When you are unsure, and you have been unsure for more than a day, let a person decide with you.
• When it is about a child, a pregnancy, or someone frail, your threshold is lower.