Medical Warning Signs Professionals Say Shouldn’t Be Ignored

"For the last couple days my kid's gums bleed like crazy when I brush his teeth, it's strange!" (Cancer)

Any kid younger than 12 complaining of back pain trigger my pinna to twitch. (Cancer/infection)

"He was breathing really, really fast a while ago, but now he's starting to slow down and sleep some." (Respiratory arrest)

Paramedic: "He was fine an hour ago but started feeling nauseous and threw up before laying down"

Come into the room to find a pool of sweat and grabbing their head with a pale face complaining of 10 pain in head. My life just got 100x worse for the next hour while I attempt to transport this pt to the only hospital within an hour going 95 down the open highway.

Sudden sensorineural hearing loss is an ENT (semi) emergency! The front office of every ENT knows to triage them in quick. Not that putting them on steroids raises the chance above natural recovery of hearing all that much. It just [is bad] telling somebody "we have nothing to offer you it's been 3 months also have you heard of a cochlear implant 🤗...".

1)After a "Succesfull" Epidural block the patient starts complaining of shortness of breath, then stops talking, then stops breathing = accidental subarachnoid injection.
2) Intraoperative rising EtCO2 and rising patient temperature = Malignant Hyperthermia.
3) Pediatric patient develops intraoperative bronchospasm, then a rash then full blown shock = latex allergy.

Prodromal schizophrenia sxs, which can be mainly the "negative " symptoms like uncharacteristic social withdrawal, loss of motivation, anhedonia in a patient who does not otherwise appear to meet MDD criteria. If you question closely, you may find they actually do have subtle positive symptoms-- sensory distortions, unusual thoughts and sensations.

Infant, six months old, "just does these odd arm lunges sometimes."

West syndrome.

OB: Hypertensive pregnant patient who presents with epigastric pain to the point she is rocking in the bed, or with severe intractable nausea and headache, or with "new shakiness". Start the MgSO4!

Fevers with bone pain. There's the usual myalgias accompanying any sort of viral infection, and then there's the bone pain of acute leukemia when they're wheeled in and placed on a PCA.

In Emergency Medicine, I've heard "if the patient is sweating, you should be sweating because something bad is going on". Or they are withdrawing which looks miserable, but less life threatening.

Yes it's common. You'd find the new 2022 acute chest pain pathway from ACC interesting to read then.

Cardiac chest pain may present like this (quoting them):
"Symptoms described as a pressure, tightness, squeezing, heaviness, or burning should be considered consistent with ACS. Pain locations other than the chest can also occur and include the shoulder, arm, neck, back, upper abdomen, or jaw. Other associated symptoms include shortness of breath, nausea, vomiting, diaphoresis, fatigue, and mental status changes, which, in some cases, may be the predominant symptom. In contrast, symptoms described as sharp, fleeting, related to inspiration (pleuritic) or position, or localized to a single point are unlikely to represent myocardial ischemia."

I.e. anything other than sharp/pleuritic pain is a fair game for cardiac pain. Burning pain is not automatically a GERD/GORD!

Children who are older with well thought out asthma plans for viruses who come into ED because it just isn't working 'anymore' should set of alarm bells.

Bonus points for
- we have been battling this for 3 or more days
- sleep is disturbed
- child is anxious about sleep
- they really hates cannulas, they will just keep crying as hard as they can
- they are far too little to understand and comply with bipap

That kid is asking for a tube, it will not be easy to keep them oxygenated since they are trapped, collapsed, plugged. And a child with hypoxic brain injury secondary to your intubation is just such a sad prospect.

My least favorite (resident clinic): Metabolic appearing patient with complaint of numbness and burning in feet. A1c at this point is just a number, and we won't be able to fix the foot pain. Let alone the retinopathy and nephropathy.

Diabetic with epigastric funny feeling and/or nausea. With my luck it's a silent MI. Had one the other day brought in as food poisoning.

Sudden onset of coughing, especially when related to positional changes, in a post-pneumonectomy patient. (Bronchopleural fistula).

Unilateral wheezing is no bueno and needs imaging

New clubbing in an Copd patient is a worrisome finding.

Any symptom that is steadily worsening and not responding to treatment. Any at all. It's almost always a good prompt to tell that patient to maybe hang around for some additional studies and it's a marker for the kind of patient that requires some time to pause whatever you're doing and consider "is there anything severe that we're missing or do I have enough information to handle this person as an outpatient"

Personally I believe any patient who has a symptom that meets those conditions, regardless of how irrelevant it may seem always warrants close following.

Kinda specific, but new onset afib after esophagectomy or bowel resection.

It’s most likely due to fluid shifts, or circulating catecholamines, or the normal [nonsense]…but everyone should ask themselves *”could this be an anastomotic leak?”*.

1. Middle aged Indian male "I've got a little tickle in my chest."= STEMI

2. Older smoker with cough and SOB x 3 weeks. Just gave up their 2 pack a day habit a week ago. = CANCER.

I was shocked to see how long some elderly patients had been having melena, but never told their doctor about it, or the times it has “accidentally” come up.

Yeah, I have been told my voice has changed recently, oh and if I lie flat I just cough and can't breathe at all. But thats fine, because my bears is still as glorious as ever

Anaesthesia.