How do you know when your flu symptoms warrant a trip to the emergency room (ER)? 

“It’s a tough call,” said Joel Geiderman, MD, 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.”

The flu isn’t usually an emergency for people who are under age 65 and otherwise healthy. But it can be deadly for people in the following high-risk groups:

• Patients 65 years old and older
• Pregnant women
• People who are immunocompromised
• People who have one or more chronic health conditions, such as heart disease or asthma

“People in these high-risk categories who experience severe flu symptoms such as fever, chills and body aches should not hesitate to go to the ER if there are no other options,” said Geiderman.

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

People who smoke or vape also have a significantly higher risk of developing flu-related complications and should see a doctor if they have flu-like symptoms, even if they don’t fall into a high-risk group.

Read: Flu and RSV: How to Protect Yourself Now

The most common flu symptoms include:

• Fever
• Chills
• Cough
• Sore throat
• Body aches
• Fatigue

People who do not fall into a high-risk category can typically recover from these symptoms at home without a doctor’s visit.

Antiviral medications may be an option if you visit your doctor within 48 hours of the start of your flu symptoms. 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,” said Sam Torbati, MD, co-chair of Emergency Medicine at Cedars-Sinai and the Levin/Gordon Chair in Emergency Medicine in honor of Joel M. Geiderman, MD.

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 spot the flu in infants and children, especially if they’re not yet talking or walking. If you notice any of the following symptoms in an infant or child, take them to the ER: 

• 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 you still want to see a doctor, an urgent care center may be a better option than the ER. People who live in California also can use Cedars-Sinai Connect, a mobile app that provides 24/7 access to Cedars-Sinai experts for urgent issues.

Read: COVID-19 and Flu Shots Provide a Double Dose of Protection

The best defense against the flu? Be proactive with these three 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, in doctors’ offices or in other public places.

If you think you have 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.

• What are common symptoms of the flu?
  • Flu symptoms include fever, cough, chills, sore throat, body aches and fatigue.
• Who is at higher risk for flu complications?
  • High-risk individuals include older adults, pregnant women, people who are immunocompromised and those with chronic health conditions.
• When should I go to the emergency room for flu symptoms?
  • Adults should go to the ER if they are at high risk for flu complications or they experience difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, dizziness, confusion, severe or persistent vomiting, or flu-like symptoms that get better and then return.
  • Babies and children should be taken to the emergency room if they have blue skin or lips, fast or troubled breathing, extreme irritability, lack of tears when crying or fewer wet diapers than usual, not eating or drinking, fever with rash, or flu-like symptoms that appear to get better before returning with a fever and cough.
• What preventive measures can I take against the flu?
  • Get vaccinated, practice good hand hygiene and stay home if sick.
• What services does Cedars-Sinai offer for flu care?
  • Cedars-Sinai Medical Center provides emergency services, urgent care and primary care for flu-related issues. People in California can also use Cedars-Sinai Connect, a mobile app that provides 24/7 access to Cedars-Sinai experts for urgent issues.