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
Seek emergency medical care for:
Sudden, severe, or unfamiliar abdominal pain
Chest pain with breathlessness, fainting, sweating, or pressure
Sudden testicular pain or swelling
Confusion, a stiff neck, severe weakness, or difficulty waking
Swelling of the lips or tongue, wheezing, or trouble breathing after medicine
And for anyone, someone who:
has had a seizure that will not stop, or does not wake up afterwards
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 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
Contact your healthcare team promptly if an attack lasts longer than usual, feels different from previous attacks, or comes with persistent vomiting or difficulty drinking.
Foamy urine, reduced urination, or swelling around the eyes or ankles also needs timely review.
Severe or ongoing diarrhea, unusual bruising, marked muscle weakness, or dark urine while taking colchicine may indicate a medicine problem and should be assessed promptly.
And for anyone, someone who:
has a fever with a stiff neck, a rash that does not fade under pressure, or severe headache
3
Does any of this apply?
Book an appointment
These symptoms can have causes other than FMF and should not be managed as a routine attack without assessment.
Routine follow-up is appropriate if attacks are becoming more frequent, you are missing treatment because of side effects, or you want to discuss pregnancy, travel, genetic testing, or changes to your management plan.
Every sign above is quoted from the sofidex article on Familial mediterranean fever. If you are not sure, err upward — it is always reasonable to be checked.