Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services for:
Vomiting blood or material resembling coffee grounds
Black, tar-like stools with weakness, dizziness, or fainting
Severe confusion, collapse, a seizure, or difficulty waking
A known or suspected paracetamol overdose
Suspected ingestion of a poisonous mushroom or toxic chemical
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent same-day medical advice for:
New jaundice
A rapidly swelling abdomen
Fever with abdominal pain or jaundice
New confusion, unusual behaviour, or increasing sleepiness
Much less urine than usual alongside swelling or jaundice
Do not wait for symptoms after a possible paracetamol overdose.
Serious liver injury may develop before you feel unwell.
3
Does any of this apply?
Book an appointment
Arrange a routine appointment if you have persistent tiredness, itching, upper abdominal discomfort, or other symptoms that concern you.
Assessment is also reasonable if blood tests have been abnormal or you have risk factors such as heavy alcohol use, viral hepatitis exposure, diabetes, or a family history of inherited liver disease.
Every sign above is quoted from the sofidex article on Liver disease. If you are not sure, err upward — it is always reasonable to be checked.