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 confusion, extreme drowsiness, a seizure, a stiff neck with severe headache, difficulty waking, or other signs of serious illness.
These are not typical of a simple ear infection.
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 prompt medical advice for severe or increasing pain, ongoing fever, new discharge, marked hearing loss, dizziness, repeated infections, or symptoms that are not beginning to improve.
Babies, people with weakened immune systems, and people with diabetes may need earlier assessment.
Get urgent same-day medical help for:
Redness, tenderness, or swelling behind the ear
An ear that appears pushed outward
Sudden hearing loss in one or both ears
Severe outer ear pain in someone with diabetes or reduced immunity
New facial weakness
A child or adult who appears very unwell
And for anyone, someone who:
has a fever with a stiff neck, a rash that does not fade under pressure, or severe headache
has a wound that is hot, spreading red, or leaking pus
Every sign above is quoted from the sofidex article on Ear infection. If you are not sure, err upward — it is always reasonable to be checked.