Emergency: Hearing, Tinnitus, and Balance Safety Guide | UCSF EARS
Safety guide

Emergency: Hearing, Tinnitus, and Balance Safety Guide

This page helps you choose the right level of care for sudden hearing changes, tinnitus (ringing or “whooshing”), and severe dizziness/vertigo. It does not diagnose you.

If you think you are having a life-threatening emergency, call your local emergency number now. In the U.S., call 911.

What to do right now

Step 1: Check for danger signs

If any danger sign is present, do not wait for a clinic appointment.

Call 911 or go to the ER now if you have hearing/tinnitus/dizziness symptoms plus any of these:

  • Facial weakness or facial numbness (new)
  • New weakness or numbness on one side of the body
  • Trouble speaking, understanding, or new confusion
  • Severe headache that is new or “worst headache,” especially with neurologic symptoms
  • Fainting, seizure, or you cannot stay awake
  • Severe vertigo/dizziness and you cannot walk safely
  • Major head injury or symptoms after trauma (especially blood/fluid from the ear)

Step 2: If no danger signs, decide “today vs soon”

Urgent evaluation today (same day) is recommended for:

  • Sudden hearing loss (one ear or both) that starts over hours to 3 days
  • A sudden “muffled” ear with new tinnitus or ear fullness
  • Severe vertigo/dizziness with new hearing change (even without neurologic symptoms)
  • Hearing change after a very loud noise or blast

If you cannot reach a clinic quickly, urgent care or the ER can still be appropriate—especially for sudden hearing loss.

Get checked soon (within days) for:

  • Pulsatile tinnitus (a whooshing or thumping that matches your heartbeat), especially if new
  • New one-sided tinnitus or one ear clearly worse (even without sudden hearing loss)
  • Dizziness/imbalance that is persistent or worsening (but no danger signs)

Pulsatile tinnitus is often not dangerous, but it can sometimes be a sign of a condition that needs medical evaluation.

What to say when you call

Try this script:

“I have a [sudden hearing drop / new pulsatile tinnitus / severe vertigo] that started on [date/time]. I also have [ringing / one-sided symptoms / ear fullness / nausea]. I need advice on the right level of care and whether I should be seen today.”

Step 3: Use EARS tools to plan your next move

Already stable/chronic? Go to the tinnitus roadmap section: When to get checked.

References

  • AAO-HNSF. Clinical Practice Guideline: Sudden Hearing Loss (Update). Read
  • NIDCD. Sudden Deafness (Sudden Sensorineural Hearing Loss). Read
  • CDC. Signs and Symptoms of Stroke. Read