Any of the following is acted on immediately. Time-sensitive and life-threatening conditions are escalated to urgent care or EMS first; provider notification and orders follow.
Red flags — act immediately
Sudden hearing loss in one ear over hours to days → urgent ENT evaluation — sudden sensorineural hearing loss is time-sensitive and treatable if caught early.
Acute vertigo with new gait unsteadiness, slurred speech, diplopia, weakness, or severe headache → central cause / stroke — run BE-FAST and activate EMS (cross-reference Neurological).
Severe otalgia with postauricular swelling, erythema, a protruding ear, and fever → mastoiditis — urgent evaluation.
Purulent ear drainage with significant pain or systemic signs → complicated otitis; notify urgently.
Acute vertigo with vomiting and a high fall risk → protect from falls and notify; treat as a safety emergency (cross-reference Safety).
Sudden severe ear pain with drainage after trauma or a foreign body → possible perforation or injury; notify urgently.
