When to go to the Emergency Room

General guidelines for when to go to the emergency room:

Always call 911 if the person has collapsed, had a seizure, not breathing or can't be awakened.

Infants:

  • Fever - Contact your on-call nurse or doctor to discuss the best options.
    • Typically a fever of 100.3 degrees or higher for infants under 3 months
    • Fever of 105 degrees or higher for babies 3 months and older after Tylenol or ibuprofen is taken can be worrisome.
  • Trouble breathing
    • Nostrils moving outward when breathing in
    • Visible ribs or collarbone when breathing in
  • If your baby turns blue or changes skin color (pale, yellow)
  • Having trouble waking up
  • Changes in muscle tone
  • Seizures

Children:

  • A fever and stiff neck, dehydration
  • Trouble breathing
    • Nostrils moving outward when breathing in
    • Visible ribs or collarbone when breathing in
  • Broken bone; open wound; or numb, tingling feeling
  • Ingested a toxic chemical
  • Took drug not prescribed to child

Adults:

  • Signs of heart attack
    • Pressure, squeezing in the chest
    • Sudden shortness of breath
    • Pain in the arms, back, neck, jaw
  • Signs of a stroke
    • Sudden weakness or numbness
    • Sudden dimness or loss of vision
    • Slurred speech, trouble talking
    • Severe headache
    • Unexplained dizziness
  • Severe shortness of breath
  • Loss of consciousness
  • Poisoning
  • Sudden and severe pain
  • Major injury or head trauma
  • Severe allergic reaction

Emergency room visits are covered outside of the Avera network, when unexpected medically necessary and emergent situations arise that could put your health at risk. Examples of medically necessary situations are: severe allergic reactions, fainting and chest pain. Be sure to give the ER staff your member ID card and call Avera Health Plans for any preauthorization needs. Keep in mind, if extended care is needed that you need to be transferred to in an in-network facility.

If you're still unsure, you can talk with a registered nurse by calling the Avera Health Plans 24/7 Nurse Hotline at 605-322-1354, or log on to AveraNow to discuss your concerns with a provider.