At what point should I go to Accident and Emergency (A&E)?

When to Go to Accident & Emergency (A&E)

You should go to A&E immediately for severe chest pain lasting more than 15 minutes, difficulty breathing, signs of stroke, severe allergic reactions, uncontrolled bleeding, or any life-threatening emergency. 1

Emergency Conditions Requiring Immediate A&E Visit

Cardiac Emergencies

• Go to A&E immediately for chest pain that is severe, lasts more than 15 minutes, and is still present when you call for help 1
• Chest discomfort associated with sweating, nausea, vomiting, radiation to throat, shoulder, arms or upper abdomen requires urgent A&E assessment 1
• Call emergency services (999/112) immediately for anyone with chest pain or other signs of heart attack rather than trying to transport the person yourself 1
• While waiting for emergency services, taking aspirin may be appropriate if heart attack is suspected and there are no contraindications such as bleeding disorders 1

Breathing Difficulties

• Seek immediate A&E care for increased respiratory rate (>24/min), severe difficulty breathing, or use of accessory respiratory muscles 1
• Oxygen saturation below 90% requires urgent medical attention 1
• Asthma attacks not responding to prescribed inhalers require A&E assessment 1

Neurological Emergencies

• Use a stroke assessment system (such as FAST - Face, Arms, Speech, Time) and go to A&E immediately if signs of stroke are present 1
• Loss of consciousness or inability to follow simple commands requires immediate emergency care 1
• Seizures, especially in someone without a known seizure disorder, warrant A&E assessment 1

Severe Allergic Reactions

• Go to A&E immediately for suspected anaphylaxis (severe allergic reaction) with symptoms like swelling, breathing difficulty, or feeling faint 1
• If prescribed, use epinephrine auto-injector (0.3 mg for adults >30 kg, 0.15 mg for children 15-30 kg) and then go to A&E 1

High-Risk Features Requiring A&E Assessment

Vital Sign Abnormalities

• Heart rate below 40 or above 100 beats per minute 1
• Blood pressure that is very low (systolic <100 mmHg) or very high (systolic >200 mmHg) 1
• Cold extremities with elevated jugular venous pressure suggest circulatory compromise requiring urgent assessment 1

Diabetic Emergencies

• Go to A&E if a person with diabetes is unconscious, having seizures, or unable to follow simple commands or swallow safely 1
• Severe hypoglycemia not responding to oral glucose requires emergency care 1

Trauma and Bleeding

• Uncontrolled bleeding or deep wounds that may need suturing require A&E assessment 1
• Suspected fractures, especially if there is deformity, severe pain, or inability to bear weight 1

When to Consider Alternative Care Options

• For minor injuries or illnesses, consider urgent care centers, walk-in clinics, or GP services 1
• For chest pain that is clearly non-cardiac (e.g., reproducible with movement or pressure), brief in duration (<5 minutes), or localized to a very small area, you may consider consulting your GP first 1
• Low-risk patients with chest pain who have been evaluated and found not to have evidence of myocardial infarction have a low risk of adverse events (cardiovascular mortality 0.1-0.5% at 4 weeks) 2

Common Pitfalls to Avoid

• Delaying seeking care for chest pain to see if it resolves - this can significantly reduce treatment options for heart attacks 1
• Driving yourself to A&E with potentially serious symptoms - call emergency services instead 1
• Attributing chest pain solely to indigestion or musculoskeletal causes without proper medical evaluation 3
• Waiting too long after the onset of stroke symptoms - "time is brain" and prompt treatment is essential 1

Remember that early assessment of potentially serious symptoms saves lives. When in doubt about the severity of your condition, it is better to seek emergency care than to wait and risk complications.