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 possible acute porphyria symptoms when there is:
Severe or rapidly worsening abdominal pain
New muscle weakness, trouble walking, or difficulty lifting the limbs
Trouble breathing or swallowing
A seizure, collapse, marked confusion, or unusual drowsiness
Repeated vomiting with difficulty keeping fluids down
Severe symptoms in someone known to have an acute hepatic porphyria
Tell the emergency team about the porphyria diagnosis or family history.
Acute testing should ideally include urine PBG and ALA before specific treatment, but necessary care should not be delayed.
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
Does any of this apply?
Book an appointment
Arrange prompt, non-emergency medical advice for new blistering, wounds that are not healing, signs of skin infection, repeated milder abdominal episodes, or possible medicine-related symptoms.
Routine specialist follow-up is appropriate when you are well.
It can be used to review medicine safety, skin protection, family testing, attack planning, and recommended kidney and liver monitoring.
Every sign above is quoted from the sofidex article on Mixed hepatic porphyria. If you are not sure, err upward — it is always reasonable to be checked.