Safe to say, no one wants to go to the emergency room. It's nearly impossible to admit to yourself that you are in crisis. In that time of crisis, you have to circumvent the emotional aspects of an emergency and just get the help you need -- and get it fast. It helps to know ahead of time what circumstances and medical situations are true emergencies. Because when you are in the midst of it, there can be no denying it.
Usual Warning Signs of a Medical Emergency
The American College of Emergency Physicians offers a list of warning signs that point to a medical emergency. The warning signs include:
- difficulty breathing or shortness of breath
- chest or upper abdominal pain or pressure
- fainting, sudden dizziness, weakness
- changes in vision
- confusion or mental status changes
- sudden or severe pain
- uncontrolled bleeding
- severe or persistent vomiting or diarrhea
- coughing or vomiting blood
- suicidal thoughts
- difficulty speaking
- unusual abdominal pain
There are not many surprises on the list. The dozen or so signs and symptoms listed are well-recognized emergency situations -- deserving of a trip to an emergency room or a 911 call for emergency assistance and transport. Beyond these well-known emergency situations, there are other circumstances recognized as critical for rheumatic disease patients. Especially in patients with connective tissue diseases or vasculitis, there can be unique dangerous and life-threatening circumstances that require immediate treatment.
Rheumatological Emergency
Other situations that are considered rheumatologic emergency include:
- septic arthritis
- gout attack
- atlantoaxial subluxation with spinal cord damage (e.g., rheumatoid arthritis)
- renal crisis (e.g., scleroderma)
- digital ulcers/gangrene (e.g., scleroderma)
- blood clots (e.g., anti-phospolipid antibody syndrome)
- amaurosis fugax - sudden, painless, temporary loss of vision in one eye (e.g., giant cell arteritis)
- pulmonary-renal syndrome (e.g., vasculitis)
- severe infection
The Bottom Line
It is important to be aware of usual medical emergencies, but rheumatic disease presents another level of complication and possible emergency situations. Be most vigilant about sudden changes or situations that seem severe. Discuss with your health care provider possible emergencies that could arise with your form of arthritis. Trust your first instinct about going to the emergency room. Don't overthink whether you should go or not. It's better to be safe than sorry.
Sources:
Interdisciplinary emergencies in rheumatic diseases. Pub Med. April 2010.
http://www.ncbi.nlm.nih.gov/pubmed/20358496
About Emergencies. American College of Emergency Physicians Foundation. Accessed 09/18/10.
http://www.emergencycareforyou.org/YourHealth/AboutEmergencies/Default.aspx?id=26018
