Last updated June 29, 2020

The coronavirus has made us all understandably cautious about visiting the doctor or the hospital. We've postponed appointments or managed our care through virtual visits, trying to stay safe from the virus by staying home. While it's important to keep taking the precautions of thorough handwashing, avoiding touching your face and wearing a mask in public, it's just as important to know when you need medical attention in the emergency department.

A number of conditions require emergency care, and our emergency room doctors, nurses and other staff members are trained in saving lives while keeping our patients safe. They are ready to act quickly when every second counts. When should you call 911 or make a trip to the emergency room? We checked in with one of UCSF Health's stellar emergency room physicians, Dr. Jacqueline Nemer, to find out. Here are 12 symptoms she says you should never ignore, even during the pandemic:

1. Sudden discomfort in the chest, back or neck

Any pain, pressure or squeezing sensation in the chest, back, jaws, neck or along the arms that comes on abruptly and lasts more than a few minutes, or goes away and comes back, may signal a heart attack.

Not everyone will feel a heart attack in the chest; women in particular often experience other signs. These may include pain in the jaw, neck or arms; difficulty breathing; light-headedness or dizziness; nausea or indigestion; fatigue; or a cold sweat. Of course, there are many conditions other than a heart attack that can cause these symptoms. It's time to head to the ER if these symptoms are new, last more than a few minutes, or go away and come back.

2. An abrupt change in behavior or function

Several mental and physical symptoms may be signs of a stroke, seizure or other serious problem. These signs include confusion; loss of coordination, strength, sensation or balance; difficulty speaking; and facial drooping.

3. Light-headedness or fainting

If you experience unexplained fainting, light-headedness, dizziness, balance problems or a sensation that the room is spinning, you need to be evaluated by health professionals. These symptoms have a wide range of possible causes that can be managed in the ER.

4. Sudden vision loss

Abrupt loss of vision in one or both eyes, either with or without pain, could be a sign of stroke or a serious blockage of blood flow to the eye.

5. Severe headache

Any new intense headache or different type of headache than you've ever experienced may be signaling a serious problem, including a stroke, dangerously high blood pressure, an aneurysm (bulge in an artery wall) or an infection.

6. Severe abdominal pain

A number of emergency problems – including appendicitis, pancreatitis, a flare-up of inflammatory bowel disease (IBD), diverticulitis, an intestinal blockage or an infection – may be indicated by abdominal pain that begins suddenly or gradually but worsens over time, particularly if accompanied by symptoms such as nausea, vomiting, diarrhea, abdominal tenderness, swelling or bloody stools.

7. Swelling in the face or mouth

Sudden swelling of your face, lips or throat or sudden difficulty swallowing, breathing or speaking may indicate a serious allergic reaction. Even if you used an EpiPen, you should be evaluated in the ER because the condition can worsen quickly.

8. Severe vomiting or diarrhea

Uncontrolled vomiting or diarrhea, especially if you’re losing more liquid than you’re taking in, can quickly lead to severe dehydration and dangerous electrolyte losses. You may require treatment such as medications to control symptoms and IV fluids.

9. Persistent fever

Fever that doesn’t resolve with an over-the-counter fever medication – especially if you are also experiencing pain, rash or any sign of infection – calls for emergency assessment.

10. Worsening rash

A painful rash that worsens quickly may indicate a serious infection.

11. Change in heartbeat

If you suddenly sense that your heart is beating faster or slower than usual, or beating irregularly, and this feeling persists, you should be evaluated in the ER, especially if you also experience light-headedness, dizziness, difficulty breathing or pain.

12. Any new bleeding

If you experience uncontrolled bleeding from your nose, gums or a wound, or notice blood in vomit, urine or stool, you should go to the ER. New bleeding must be evaluated by health professionals, especially if you also have symptoms such as light-headedness, dizziness or weakness.