Certain symptoms, illnesses, and injuries may require emergency treatment.

Going to the ER can be tough at any time of the year. But during the holidays, it’s probably the last place you want to be. No matter how much we appreciate the doctors and nurses postponing their own festive celebrations to care for the sick and the injured, we want to be at home, tucking into tasty leftovers or enjoying a Christmas movie marathon.

Caesar Djavaherian, MD, an emergency room physician and co-founder of San Francisco-based Carbon Health, says certain issues seem to present to the emergency department more commonly over the holidays. Here are some common illnesses, injuries, and symptoms of the season.

Chest pain

Unexplained chest pain can be alarming, but it doesn’t necessarily mean you’re having a heart attack, says Harvard Medical School. While millions of Americans with chest pain are seen in the ER every year, only 20% of them are diagnosed with a heart attack or an episode of unstable angina (a warning sign of an imminent heart attack). Other causes of chest pain include pancreatitis, pneumonia, and panic attack.

Shortness of breath

According to the U.S. Centers for Disease Control and Prevention(CDC), shortness of breath (known medically as dyspnea) is one of the main symptoms of heart attack. But this feeling of intense tightening in the chest, difficulty breathing, or breathlessness may also be caused by very strenuous exercise, extreme temperatures, or obesity in an otherwise healthy person, per Mayo Clinic.

Cold/flu symptoms

The cold and flu are both respiratory illnesses, but they’re caused by different viruses. Cold symptoms are usually milder than flu symptoms. The symptoms of the flu can include fever or feeling feverish/having chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue (tiredness). Cold symptoms (sneezing, stuffy nose, and sore throat) are usually milder than the symptoms of the flu (commonly fever, aches, fatigue, chest discomfort, and headache), says the CDC.

The vast majority of people really don’t have to go to the ER for a cold or the flu, but if you have the flu and also experience some warning signs, like persistent pain or pressure in the chest or abdomen, persistent dizziness, seizures, or an inability to urinate, the ER is the right place to go.

Abdominal pain

If you experience acute (sudden and severe) abdominal pain, you could have acute pancreatitis (inflammation of the pancreas), appendicitis (inflammation of the appendix), or cholecystitis (inflammation of the gallbladder). Or it might be constipation, diarrhea, or inflammatory bowel syndrome (IBS). The Medical University of South Carolina advises seeking immediate medical care if you also have bloody bowel movements, vomit that appears to have blood in it, trouble breathing, or abdominal pain during pregnancy.

RELATED: 9 Serious Conditions That Can Feel Like Heartburn

Accidental injuries

While cuts, contusions, and fractures can occur any time of the year, the holiday season ushers in a host of weather- and festivity-related mishaps. Cold weather plus physical exertion can be a dangerous combination, cautions the American College of Emergency Physicians (ACEP).

One study by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, found that roughly 11,500 people are treated in U.S. emergency departments each year for injuries and medical emergencies due to snow shoveling, for example. The damage included slips or falls; pain or injury due to musculoskeletal exertion; being struck by a shovel (ouch!), and heart issues ranging from chest pain and arrhythmia to heart attack. For people with existing cardiac risk factors, the increased strain of removing snow in freezing temperatures can just be too much, researchers reported.

And then there are the Clark Griswolds of the world who risk life and limb to pull off fabulous light displays. Don’t be the bumbling character in National Lampoon’s Christmas Vacation. ACEP encourages people to use common sense when hanging lights.

Vomiting 

Festive vomiting could be a sign of norovirus illness, also known as the stomach flu or stomach bug. According to the CDC, if you have norovirus, you’re likely to feel extremely ill and vomit or have diarrhea several times a day, which can make you dehydrated.

Look out for a decrease in urination, dry mouth and throat, and feeling dizzy when standing up. If you’re dehydrated and can’t stop vomiting, you might need hospitalization to get intravenous fluids.

Mental health and alcohol-related episodes

Dr. Djavaherian points out that ER visits over the holidays reflect spikes in mental health conditions and alcohol-related illnesses. If you have depression or are prone to drinking excessively, he recommends reaching out to friends, family, or community groups to ask for support—and a oid to the ER.

In general, taking action at the first sign of a health issue can help keep you out of the ER over the holidays. This means paying attention to your body (and mind) and not ignoring any symptoms in the hope they’ll just go away. “If you notice you are coming down with an illness, or you have a nagging pain in the week leading up to Christmas, get it checked out with your doctor or the local urgent care center,” Dr. Djavaherian says.

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