30 min
maximum acceptable delay for a heart attack
AHA
6 hrs
window to save a testicle in torsion
Urology guidelines
3 hrs
thrombolysis window for ischaemic stroke
Stroke guidelines
24 hrs
corneal damage risk from gonococcal eye infection
WHO
The Most Important Decision in Emergency Medical Care
In Lagos, the choice between going to a by appointment clinic like Mascot Healthcare or going directly to a hospital emergency department (A&E) is not always obvious. Making the wrong choice — either going to A&E for something manageable in primary care, or going to a by appointment clinic when you need emergency care — can cost time that cannot be recovered.
This guide is direct and clear: here are the symptoms that require A&E, and here are the symptoms that are appropriate for Mascot Healthcare.
GO TO A&E IMMEDIATELY — Do Not Come to Mascot Healthcare First
These symptoms require emergency hospital care — call for help and go directly to the nearest A&E:
Cardiovascular
- Severe crushing central chest pain, especially with sweating, arm pain, or jaw pain
- Sudden severe shortness of breath at rest with coughing of blood or leg swelling (pulmonary embolism)
- Heart rate above 150 or below 40 beats per minute with symptoms
- Collapse or loss of consciousness
Neurological
- Sudden facial drooping, arm weakness, or speech difficulty — FAST: Face, Arms, Speech, Time — stroke until proven otherwise
- The worst headache of your life, sudden onset (thunderclap headache) — subarachnoid haemorrhage until proven otherwise
- Seizure lasting more than 5 minutes or repeated seizures without regaining consciousness
- Sudden loss of vision in one eye
Surgical and abdominal
- Severe, constant abdominal pain — not colicky, not related to position — especially if the abdomen is rigid
- Vomiting blood or passing large amounts of fresh blood from the back passage
- Sudden, severe one-sided scrotal pain in a young man — testicular torsion (6-hour window to save the testicle)
- Ruptured ectopic pregnancy — positive pregnancy test with one-sided pain and collapse
Obstetric
- Heavy vaginal bleeding in pregnancy (antepartum haemorrhage)
- Eclamptic convulsion in a pregnant woman
- Absent fetal movement for more than 12 hours in the third trimester
Paediatric
- Child under 3 months with any fever above 38°C
- A child with a non-blanching rash + fever (press a glass against it — if it doesn't fade, go immediately)
- A child with severe respiratory distress (ribs visible with every breath, lips turning blue)
- A child who is unresponsive or cannot be roused
COME TO MASCOT HEALTHCARE — These Are Appropriate for a Same-Day Appointment
- Fever, malaria symptoms, cough, cold, sore throat — same day, by appointment
- Vaginal discharge, UTI, vaginal infection — same-day treatment
- Penile discharge, STI concerns — confidential, same day
- Blood tests, scans (pelvic, pregnancy, abdominal) — by appointment, same-day report
- Chronic disease reviews (diabetes, hypertension, thyroid) — regular monitoring
- Skin conditions, wounds, abscess — minor procedures same day
- Moderate chest pain with no collapse and normal vital signs — assessment with ECG
- Moderate abdominal pain with normal vital signs — assessment and investigation
When You Are Unsure
If you are genuinely unsure whether your symptoms are an emergency, call Mascot Healthcare on 0816 586 6252 — we will advise honestly whether to come to us or go to A&E. We do not want patients with emergency conditions in our waiting room.
About the author: Dr. Adebayo Okonkwo is general practitioner, mascot healthcare at Mascot Healthcare, Akoka, Lagos. This article is reviewed annually and updated to reflect current guidelines and data.