When should you go to the emergency room? Expert shares symptoms that could warrant a trip to the hospital

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Canadians are heading to the emergency department (ED) in droves — but not always for "emergency" situations. According to a new report from the Canadian Institute for Health Information (CIHI), one in seven visits to the ED in Canada are for issues that could potentially be managed by a family doctor or other primary health-care provider like a nurse practitioner.

The report, which was published earlier this month, focused on data from April 2023 to May 2024. According to CIHI's findings, the lack of access to a family doctor (or access to timely appointments), walk-in clinics or other primary care physicians forced many Canadians to turn to the ED for antibiotic prescriptions or prescription refills, as well as treatment for conditions like colds, sore throats and ear infections. Children aged two to nine years old and people in rural areas were most likely to use the ED for primary care.

Dr. Alim Pardhan, chief of emergency medicine with Hamilton Health Sciences in Hamilton, Ont., understands why many Canadians are turning to the ED for primary care. Pardhan says it's not uncommon for people to visit the ED, particularly when they have concerns after-hours, in the middle of the night or on weekends.

As cold and flu season continues and the holidays quickly approach, many Canadians may find themselves in a dilemma with accessing care. Office closures and busy schedules may leave many to wonder: When should I go to the emergency room? Pardhan says there are a few worrying symptoms that might warrant a trip to the ED.

Trouble breathing

"The biggest thing is trouble breathing," Pardhan tells Yahoo Canada. "If you or your child is having trouble breathing, that's a good reason to come to the emergency department."

Pardhan says to look and see if there are muscles tugging between the ribs or at the trachea, which is located in the lower neck or top of chest area. The inward motion of the chest wall when inhaling could be a sign of respiratory distress and requires medical attention. Other signs of respiratory distress can include:

• Breathing faster than normal

• Change in colour (pale, bluish or grey)

• Loud grunting when exhaling

• Sweating

• Wheezing

• Leaning forward to take deeper breaths

• Nose flaring to take deeper breaths

Dehydration

Remaining hydrated is key to helping our bodies fight off infection. However, if someone is refusing liquids, vomiting or having diarrhea, Pardhan says it's best to make an ED visit. Signs of dehydration in children can include:

• Dry tongue and lips

• Rapid breathing

• Cold hands or feet

• No tears when crying

• Fewer than six wet diapers for infants

• No wet diapers for eight hours for toddlers

Signs of dehydration in adults can include:

• Headache

• Muscle cramps

• Swollen feet

• Fatigue

• Dizziness

• Confusion

• Dark yellow urine

• Lightheadedness

• Fainting

Lethargy

Pardhan says a noticeable change in behaviour as well as someone "not waking up" or being "difficult to rouse" is a worrisome symptom that requires medical attention. People may appear drowsy, sleepy or confused in these scenarios.

When should I be concerned about a fever?

Navigating fevers can be incredibly stressful for parents of young children. Although they can last for several days, Pardhan says a fever on its own isn't necessarily a cause for concern.

"Fever in and of itself is not particularly dangerous," he says. "Fever is your body's natural response to an infection. ... Generally, we tell people if someone has a fever for more than five days, they should probably be assessed by someone."

Pardhan says any child under two months of age with a fever should be assessed or brought to the ED as soon as possible. For anyone over the age of two months, fever in conjunction with symptoms like lethargy, dehydration or trouble breathing would warrant a trip to the ED.

Seniors and emergency room visits

Pardhan says it's not uncommon for families who gather during the holidays to notice a change in the health of their loved ones and become concerned.

"They're confused, they're not behaving normally, they're significantly more weak than they were before. ... Those are all markers something more serious is going on," he says. "Bringing them in for an assessment is certainly a good idea."

Pardhan says any sign of confusion, shortness of breath or dehydration can warrant a trip to the ED. If your loved one doesn't seem to be cognitively impaired, you may want to consider discussing their health with their primary care provider.

Will I be seen faster if I call an ambulance?

All incoming patients are assessed by triage nurses — no matter how they arrive at the hospital. It's possible that patients who arrive by ambulance can be offloaded to the waiting room, so there's no guarantee you'll be seen faster if you call 911.

"There is the potential for a longer wait time in the emergency just by virtue of the fact that we're trying to see our sickest patients first where early intervention is really important," Pardhan says.

'We're certainly happy to see you'

It can be stressful to feel under the weather or see your loved one struggling. Not having access to same-day appointments or having a primary care provider to visit can prompt many people to debate spending long hours in the ED waiting room. Still, it's a good idea to seek help when you think you need it.

"If you're worried for whatever reason, that's usually a good enough reason to go to your primary care physician or come see us [in the ED]," Pardhan notes. "If you're worried enough to make the trip, we're certainly happy to see you."

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