I'm An ER Nurse — 6 Subtle Signs Of Medical Emergencies You Should Never Ignore
Recognizing these symptoms could save your life or that of a loved one.
ANTONI SHKRABA production | Pexels Some medical emergencies are obvious. Profuse bleeding from a stab wound or severe crushing chest pain, for example. Other medical emergencies have far more subtle symptoms that might seem minor. A woman in her 40s once came into my ER with what she thought was nothing more than a bad belly ache.
By the time she finally decided to get herself to the hospital, she was weak and pale. It turned out she had a ruptured aorta that was slowly bleeding into her abdomen. Tragically, that story did not have a happy ending. In my time behind the triage desk, I have witnessed many heartbreaking outcomes in people like her who didn’t recognize the need for immediate medical attention and waited too long to come in. Some life-threatening conditions don’t look like obvious emergencies
Here are six subtle signs of medical emergencies you should never ignore:
1. You see flashes or shadows in your vision
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Imagine you’re going about your day when suddenly, you notice flashes of light or a shadow that seems to cover part of your vision. It would be easy to dismiss this as eye strain or fatigue, but these are symptoms of retinal detachment.
The retina is a thin layer of cells at the back of your eye that converts light into nerve signals that are transmitted to the brain via the optic nerve. No retina means no vision. When the retina detaches from its usual position, it stops receiving blood flow and oxygen. This can lead to permanent blindness if not treated quickly.
Symptoms to watch for include:
- Flashes of light in one or both eyes.
- A sudden increase in “floaters” (tiny dark spots or squiggles moving in your field of vision).
- A dark shadow or “curtain” across part of your visual field.
You might be more likely to have a retinal detachment if you’ve had a recent eye injury, but it can also happen to people with Diabetes, nearsightedness, or sometimes just due to age or predisposition. So, if your vision suddenly gets weird, don’t brush it off. You only have a few hours to save your vision, so get to the nearest hospital right away. Getting a prompt diagnosis can mean the difference between saving your sight or losing it permanently.
2. Sudden, intense abdominal pain
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An abdominal aortic aneurysm (AAA) occurs when a section of the aorta, the major artery that supplies blood to your organs and lower body, weakens and bulges out like a balloon. Most AAAs develop slowly and have no symptoms — until they rupture.
Roughly 5 liters (or 1.3 gallons) of blood travels through your aorta every minute. When a AAA ruptures, it’s a life-threatening emergency, but the early symptoms can sometimes be mistaken for something like back pain or indigestion.
Symptoms to watch out for include:
- Sudden, intense abdominal or back pain that may radiate to your legs
- Fainting, lightheadedness, or sudden weakness
- One foot may be cold or numb (because of decreased blood flow to that leg)
Risk factors for AAA include high blood pressure, smoking, and being over age 60 — but they can happen to people much younger. So don’t fool around! A ruptured AAA causes severe internal bleeding, and minutes can make the difference between life and death.
3. A stiff neck accompanied by a fever
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A sore neck is pretty common, especially after sleeping in a funny position or just turning your head the wrong way. But if your stiff neck comes with a fever, severe headache, or sensitivity to light, spinal meningitis could be the culprit. Meningitis is an infection that causes inflammation of the membranes around your brain and spinal cord, and it can be viral or bacterial. Bacterial meningitis is particularly dangerous and needs urgent medical attention.
Symptoms to watch out for include:
- A bad headache that feels different from any headache you’ve had before
- Fever
- Neck stiffness that makes it difficult to touch your chin to your chest
- Sensitivity to light, known as photophobia
- Nausea or vomiting
- Feeling confused or unusually sleepy
- An unusual rash
These symptoms can escalate quickly, especially in children and young adults. Healthy, young people can die of meningitis, so if you see these symptoms get to a hospital immediately. Early intervention can prevent serious, long-term disability or death.
4. A sudden, severe headache that feels like a thunderclap
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Headaches are pretty common, but people often describe the pain of a brain aneurysm as the “worst headache of their life.” A brain aneurysm, just like a AAA, occurs when a blood vessel in the brain develops a weak spot that balloons out. If this aneurysm ruptures, it causes bleeding into the space around the brain, called a subarachnoid hemorrhage.
The symptoms of a brain aneurysm can sometimes be mistaken for less serious issues, like a migraine (imagine, calling a migraine “less serious” — that’s how serious an aneurysm is).
Symptoms to watch out for include:
- A sudden, severe headache that feels like a thunderclap or “explosion” inside your head
- Blurred or double vision
- Stiff neck
- Nausea or vomiting
- Sensitivity to light
- Confusion, trouble speaking, or unusual sleepiness
If not treated immediately, this bleeding will lead to severe brain damage or death. Brain aneurysms can often be repaired with surgery, but only if they are caught in time.
5. Chest pain or discomfort in the arm, jack, neck, back or shoulders
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When people think of a heart attack, they often imagine clutching their chest in intense pain: AKA “the Hollywood heart attack.” Unfortunately, heart attack symptoms can be far less obvious, especially in women, older adults, and people with diabetes. You can have a heart attack without ever having chest pain.
The atypical signs of a heart attack can be easily mistaken for something less serious, which is why they’re so dangerous.
Symptoms to watch out for include:
- Shortness of breath
- Discomfort in the arm, jaw, neck, back, or shoulders. This may feel “achy” or like pressure or tightness rather than pain.
- Nausea or vomiting, which can be mistaken for a stomach bug.
- Unusual fatigue that you can’t shake, even after rest.
- Lightheadedness or dizziness, sometimes accompanied by cold sweats.
Women are more likely than men to experience these atypical symptoms, and they’re also more likely to dismiss them as something minor. Every minute of a heart attack is a minute your heart muscle is being deprived of oxygen, so if you feel that something isn’t right — especially if you have risk factors like high blood pressure, high cholesterol, or a family history of heart disease — trust your instincts and get it checked out.
6. Symptoms of the FACE acronym
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We often think of strokes as a problem for older people, but they can strike at any age. A stroke occurs when blood flow to part of the brain is interrupted, either due to a blood clot blocking blood flow (ischemic stroke) or a burst blood vessel (hemorrhagic stroke). Strokes are a true medical emergency. “Time is brain,” as we say in the business, meaning the sooner you get treatment, the less brain tissue is damaged.
If the stroke is caused by a blood clot, there are medications that can break up the clot and restore blood flow, but they can only help within the first 3–5 hours from the onset of symptoms. After that, the affected brain tissue may be permanently damaged and the clot-busting medication is too risky to give.
I have seen people recover fully and go back to their normal lives after a stroke that was promptly treated. I have also, tragically, seen people ignore their symptoms and come in the next day, only to be told they will have permanent paralysis and brain damage.
Symptoms to watch out for include:
- Face: Is one side of the face drooping or numb?
- Arms: Is one arm weak or numb? Can the person raise both arms evenly?
- Speech: Is speech slurred or difficult to understand?
- Time: If you see any of these signs, it’s time to call 9–1–1.
Other symptoms can include sudden vision changes, severe headaches, difficulty walking, or loss of coordination. If you notice any of these symptoms, make sure you note the exact time they started, and call an ambulance.
When in doubt, check it out. One of the most haunting things about my career as an ER nurse is remembering the patients who waited too long to come in. I understand the hesitation — no one wants to rush to the hospital for a false alarm. But, on behalf of all the tired and probably somewhat cranky ER staff out there, I promise you, we’d rather see you and rule out something serious than have you stay home when time could have saved your life.
If you’re unsure whether your symptoms warrant a trip to the ER, remember this: it’s better to be safe than sorry. Your body has ways of letting you know when something is wrong. Trust your instincts, and don’t be afraid to seek help.
Andrea Romeo is a nurse and writer with over 20 years of experience helping people live healthier lives. She is a regular contributor to Medium publications Wise and Well and Aha!