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When to go to the ER or call 911 in Puerto Rico

Is this an emergency?

This is not an emergency service. Call 911 or go to the nearest emergency room if you have:

  • Chest pain, pressure or discomfort that lasts more than a few minutes or comes and goes
  • Trouble breathing or severe shortness of breath
  • A drooping face, weakness or numbness on one side of the body, or sudden trouble speaking or seeing
  • A seizure, fainting, confusion or being hard to wake
  • Bleeding that will not stop, a deep wound or a hard blow to the head
  • Swelling of the lips, tongue or throat, or trouble breathing after a sting, a food or a medication
  • Dengue warning signs: belly pain, repeated vomiting, bleeding from the nose or gums, blood in vomit or stool
  • Thoughts of harming or killing yourself

Help lines:

Warning signs: when to go to the ER

When to go to the ER in Puerto Rico: go right away, or call 911, if you have chest pain or pressure, trouble breathing, signs of a stroke, bleeding that will not stop, a seizure, confusion, a severe allergic reaction or dengue warning signs. Do not wait for an appointment or use a video visit. In a mental-health crisis in Puerto Rico, call Línea PAS at 1-800-981-0023 or 988.

Chest and heart: signs of a heart attack

Call 911 right away if you have:

  • Chest pain or discomfort: pressure, squeezing, fullness or pain that lasts more than a few minutes or goes away and comes back.
  • Feeling weak, light-headed or faint, sometimes with a cold sweat.
  • Pain or discomfort in the jaw, neck or back.
  • Pain or discomfort in one or both arms or shoulders.
  • Shortness of breath, before or along with the chest discomfort.

Stroke: act fast

The signs come on suddenly: numbness or weakness in the face, arm or leg, especially on one side; confusion or trouble speaking or understanding; trouble seeing; trouble walking, dizziness or loss of balance; or a severe headache with no known cause.

A quick check: ask the person to smile (does one side of the face droop?), to raise both arms (does one drift down?) and to repeat a simple phrase (is the speech slurred or strange?). If you see any of these signs, call 911 right away and note the time they started.

Breathing and allergic reactions

Call 911 if someone can't breathe, is choking, has severe shortness of breath, or has swelling of the lips, tongue or throat after a sting, a food or a medication.

Fever and dengue in Puerto Rico

Dengue is common in Puerto Rico. Warning signs of severe dengue usually begin 24 to 48 hours after the fever goes away. Go to an emergency room right away if there is:

  • Belly pain or tenderness
  • Vomiting (at least 3 times in 24 hours)
  • Bleeding from the nose or gums
  • Blood in vomit or stool
  • Extreme tiredness or restlessness

Fever with a stiff neck, or with spots on the skin that don't fade when you press a glass against them, is also an emergency. More in the guide to dengue warning signs.

Children and babies

We do not see babies under 6 months old. A baby under 3 months with a temperature of 38.0 °C (100.4 °F) or higher needs emergency care. At any age, go to the ER or call 911 if a child:

  • Is working hard to breathe: the ribs pull in, the nostrils flare, they grunt when breathing, or their lips look blue.
  • Is very floppy, hard to wake, or looks very ill.
  • Has a seizure.
  • Has a fever with a stiff neck, or with spots that don't fade when you press a glass against them.
  • Shows signs of severe dehydration: barely urinating, sunken eyes, not drinking, or vomiting everything.
  • Vomits something green or bloody.

Mental health and crisis

If you or someone close to you is thinking about self-harm or suicide, call Línea PAS now at 1-800-981-0023, or call or text 988. Both are free and confidential. If there is immediate danger, call 911. We do not use video visits for mental-health crises.

Poisoning

If someone swallowed, breathed in or touched something that may be poisonous, or took too much of a medication, call Poison Help at 1-800-222-1222, which serves Puerto Rico. If the person is not breathing, is having a seizure or will not wake up, call 911.

When to go to the ER in Puerto Rico instead of using telehealth

Telehealth is for common problems that don't threaten your life: a urinary tract infection, a sinus infection, a mild rash or a prescription refill. If you have any of the signs on this page, don't book a visit: go to the ER. If you're unsure, go. See also where to go when you're sick and what we don't do by telehealth.

Frequently asked questions

When should I go to the ER instead of using telehealth?
Whenever you have a warning sign: chest pain, trouble breathing, stroke signs, bleeding that will not stop, seizures, confusion, a severe allergic reaction, dengue warning signs, or thoughts of self-harm. Telehealth is for common problems that can wait for an appointment.
Can I call you in an emergency?
No. Our service does not handle emergencies. Call 911 or go to the nearest emergency room.

Sources

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