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Flu: When to Go to the ER

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How do you know when your flu symptoms warrant a trip to the ER? 

"It's a tough call," says Dr. Joel Geiderman, co-chair of Emergency Medicine at Cedars-Sinai

"My own mother got sick with the flu, developed severe complications, and died of it at age 76. In my opinion, her death was preventable."



Flu basics

The flu isn't usually an emergency, especially among people who are young and otherwise healthy. But for patients over 65, pregnant women, and people who are battling a chronic condition or are immunocompromised, the flu can be deadly. 

"People in these high-risk categories who experience severe flu symptoms like fever, chills, and body aches should not hesitate to go to the ER if there are no other choices," says Dr. Geiderman.

Early treatment may help these patients sidestep complications, such as bacterial pneumonia, superinfections, and even death. 

Otherwise healthy people who smoke or vape also have a significantly higher risk of developing flu-related complications and should see a physician if they are suffering from flu-like symptoms.


"The general advice for otherwise healthy people is to take over-the-counter medications to manage your symptoms, stay in bed, and drink plenty of fluids."


Should you see a doctor?

If you have the flu, antiviral medications may be an option if you visit your doctor within 48 hours. However, studies show these drugs only shorten the duration of illness by one day or less and they may come with serious side effects. 

"Rather than visiting a doctor or urgent care center to get a prescription, the general advice for otherwise healthy people is to take over-the-counter medications to manage your symptoms, stay in bed, and drink plenty of fluids," says Dr. Sam Torbati, co-chair of Emergency Medicine at Cedars-Sinai

When to go to the emergency room

Adults who have the following symptoms, even if they don't fall into a high-risk category, should go to the ER:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness or frequent dizzy spells
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms that appear to get better, but then return

It may be more challenging to pinpoint the flu in infants and children, especially if they're not yet talking or walking. Watch for these emergency symptoms:

  • Skin or lips that take on a bluish tint
  • Fast or troubled breathing
  • Extreme irritability
  • Lack of tears when crying or fewer wet diapers than usual
  • Not eating or drinking
  • Fever with rash
  • Flu-like symptoms that appear to get better before returning with a fever and cough

If you don’t have the symptoms listed above and aren’t in a high-risk group, but still want to see a doctor, an urgent care center may be a better option.



Prevention is the best medicine

The best defense against the flu? Be proactive with these 3 strategies: 

  • Get vaccinated at the start of flu season. The single best thing you can do to prevent the flu is to get a flu shot.
  • Be vigilant about handwashing. Wash your hands with soap and water, scrubbing the front and back of your hands as well as underneath the nails. A standard washing regimen should take 20-30 seconds, about as long as it takes to sing "Happy Birthday." No soap or water? Use hand sanitizer until you can get to a sink. 
  • Stay home. If you do get sick, stay away from people for at least 24 hours after your fever subsides and drink plenty of fluids. The flu is usually contagious for about a week after the onset of symptoms. You might also consider wearing a respiratory mask, especially on airplanes or in doctors’ offices or other public places.

If you think you're suffering from the flu, your symptoms aren't improving, and you aren’t severely ill or in a high-risk group, your first stop should be your primary care doctor or an urgent care center.