Got The Flu? Here's When To Head To The ER

Jenna Birch

(Photo: Getty Images)

Everyone who has ever been sick has been faced with these questions: Is your condition bad enough to get yourself, or your kids, out of bed and into a doctor’s office? Or, if sickness strikes on a weekend or after hours — which it always seems to, right? — when should you hit the walk-in or ER? 

You know the flu can be dangerous, but, when you feel horrible anyway, how do you know what’s really bad?

We often think of infections like the flu, pneumonia, or strep throat in terms of the symptoms they cause — for instance, high fever, cough or sore throat — and sometimes forget to think about the potential for complications as a condition worsens.

It’s important to be aware of what can happen if an illness progresses, according to a new overview in the journal Mayo Clinic Proceedings. In the piece, senior author Steve Peters, M.D., a pulmonary and critical care doctor at the Mayo Clinic, says that deadly sepsis is a very real risk in infections such as the flu. We caught up with him for a download on sepsis and other common flu complications — and when to get yourself or a loved one to the ER, stat. 

Who should call a their doctor right away:

Normal flu symptoms such as cough, congestion, fever, sore throat, or muscle aches do not require a trip to the ER, and usually begin to improve spontaneously in a few days’ time.

However, call your doc if you’re in a group prone to complications from flu (those over 65, those with chronic illness, children under age 5) and experience these kinds of symptoms. “Those at higher risk should seek medical care early, as there is specific antiviral treatment for influenza,” Peters says, “but it is most beneficial if given in the first few days of illness.”

When to seek urgent care:

"Those with progressive symptoms, such as shortness of breath, should seek care urgently," says Peters. If you have any trouble breathing, bluish skin, confusion, uncontrollable vomiting, extreme high fever or chest pain; are coughing up blood; or cannot take in fluids — go to the ER.

Besides sepsis, which we’ll detail more below, complications “are most often respiratory problems, including bronchitis and pneumonia, or worsening of chronic conditions such as asthma,” and can also involve muscle inflammation, central nervous disease and heart issues, Peters says. These are considered emergency symptoms and need to be treated immediately. 

But let’s get more into sepsis — what is it, exactly? 

 “Sepsis refers to the effects of inflammation caused by infections on the body, like fever and elevated white blood cell count,” Peters tells Yahoo Health. To break it down further, when you get sick with an infection, the body releases chemicals into the bloodstream to fight it off. These chemicals trigger inflammatory responses inside your body.

While the released chemicals do help fight off a bug, sometimes the resulting inflammation is too much for the body’s organs. And if the inflammation is overwhelming enough, the body can sustain damage to vital organs such as the lungs, liver, or kidneys that may put one’s life at risk.

So, sepsis is a complication of infection-based illnesses such as flu and pneumonia, but it really has symptoms all its own.

What are the symptoms of sepsis?

Classic flu symptoms are also associated with sepsis, developing from a infection, even one caused by a deep cut or open wound. It’s also generally most common among those with weakened immune systems, like the chronically ill or elderly.  

The difference between a regular infection and sepsis? The severity of symptoms. With a garden-variety infection, you would have some aches, some pains and a low-grade fever around 99 or 100 degrees Fahrenheit, but you would still be able to communicate, drink fluids and move around.

With sepsis, the patient is not functional. The illness would seem to progress from moderately bad to a whole lot worse over hours or the course of a day. Beware of high fever or refusing fluids, says Peters. “Fever, fatigue and generalized achiness are common,” he explains. “Other signs to watch for include high fever, shortness of breath, drowsiness or confusion, and an inability to keep fluids down.” If you notice these symptoms, see a doctor right away.

Why getting to a doctor is crucial

Since the condition can snowball and progressively worsen, you can’t wait if your gut says something is wrong. Prompt treatment is essential, because sepsis can quickly turn into severe sepsis. “Severe sepsis occurs when there are further signs of injury to organs of the body, such as difficulty breathing, drop in urine production, or liver damage,” says Peters. These symptoms may result in septic shock if organs start to fail — when the body isn’t responding to fluids and medications.

The worse the infection gets, the more difficult to rebound. In hospitals, septic shock is fatal in 20 to 30 percent of cases.

How is sepsis evaluated and treated?

Emergency medics and hospital workers are equipped to evaluate and tackle signs of advancing sepsis immediately. In fact, they’re on guard for them. The Mayo Clinic has even developed “sniffers” to test for early symptoms of the condition in patients with higher risk.

When people arrive at the ER, their symptoms are assessed and doctors take a culture from a blood sample, as well as from any other parts of the body that seem to be relevant or affected. They get the person on an IV, and they start antibiotics if they think sepsis is a real risk. 

The initial, primary focus of the ER team is on keeping fluids in the system, says Peters, which is something the patient with potential sepsis may not have been able to do to this point.

Can you prevent sepsis and septic shock?

Peters says sepsis is hard to prevent, but early identification and intervention are the most crucial aspects of reducing risks, along with monitoring for high fever and making sure the person stays hydrated if at all possible. “Suspicion should be high, especially in the elderly; in those with chronic diseases such as diabetes, heart failure or lung disease; and in people on immune suppressing drugs,” he says, especially now. “The frequency of sepsis in the population does vary with the seasons, increasing in the winter months, especially when related to respiratory infections and pneumonia.”

Thankfully, children are at relatively lower risk of sepsis when compared with adults, so don’t panic if your kid comes down with a bug. “Every child with a suspected infection does not need to go to the ER,” says Peters. “Parents should seek medical care if symptoms are greater than the usual upper respiratory infection, which could include difficulty breathing, change in the level of consciousness, inability to drink fluids, or prolonged vomiting.” Keep a watchful eye on your sick kids and be aware of progressing symptoms, and you should be safer this flu season.