Medical Oncologist
CION Cancer Clinics
An emergency plan to keep on the fridge when someone has liver cancer or cirrhosis | CION Cancer Clinics
If someone at home has liver cancer or cirrhosis, vomiting blood or passing black tarry stools means call an ambulance now. New confusion, fever with a swollen belly, or sudden yellowing with fever means hospital today. A single sheet on the fridge, listing these signs, the diagnosis, the medicines and who to call, saves precious minutes when the person who usually knows is not at home. At CION Cancer Clinics, our team supports patients and families through symptoms, follow-up and life during and after treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Why does a family with liver disease need an emergency plan?
- Which signs mean go now, and which mean call the doctor today?
- What should the emergency sheet actually say?
- What should the family do in the first few minutes?
- What families often think in the moment
- What this page cannot tell you
- Common questions about a liver emergency plan
The short answer
Why does a family with liver disease need an emergency plan?
Because the most dangerous problems in advanced liver disease start suddenly, often at night, and the family member who knows the history may not be at home. A written plan on the fridge tells whoever is there what the signs mean, who to call, and what to carry to hospital.
The emergencies this plan is for
In cirrhosis, veins in the food pipe can swell and burst. These are called varices, and a bleed from them is the most dangerous emergency in this disease. The liver can also stop clearing toxins, which causes confusion. Fluid in the belly can become infected. Each of these needs hospital care quickly, and each is easier to treat when it is caught early.
Who should read it
Everyone who lives in the house or stays over: a spouse, grown children, a parent, and anyone hired to help. In a joint family, the person at home in the afternoon is often not the one who goes to clinic visits. The plan is for them. Keep a copy in the bag that goes to hospital and a photo on the phone of each family member.
This plan does not replace the advice of the doctor treating the person. Ask them to look at it once and correct anything.
!
Call an ambulance now
Vomiting blood or material that looks like coffee grounds, passing black tarry or bloody stools, fainting, or becoming cold, pale and breathless all point to bleeding. Call the emergency ambulance number now and say the person has liver disease. Do not drive them yourself if they are faint, do not give food or drink, and do not wait to see if it settles. Read vomiting blood: call an ambulance now.
Not sure whether this applies to you?
Ask an oncologistSign by sign
Which signs mean go now, and which mean call the doctor today?
What you see
What to do
Vomiting blood, black stools, fainting
Ambulance now
New confusion, odd behaviour, very hard to wake
Hospital today, by ambulance if they cannot sit up
Fever or belly pain with fluid in the abdomen
Hospital today
Sudden deep yellowing with fever or shivering
Hospital today
Passing much less urine, or very dizzy on standing
Call the treating team today
Slowly growing belly, ankle swelling, poor appetite
Mention at the next visit, or call if it is changing fast
What to write down
What should the emergency sheet actually say?
One page, large print, in the language the household reads best. Telugu and English side by side works well.
The diagnosis in one line
For example, liver cancer with cirrhosis, varices seen on endoscopy. Add hepatitis B or C if present. Emergency doctors decide faster when they know this at once.
The medicine list
Every tablet, with what it is for. Mark the beta-blocker, lactulose, any water tablets, blood thinners and cancer medicines. Use one updated medicine list and change it whenever a dose changes.
Who to call, in order
- The emergency ambulance number
- The nearest hospital with an emergency department
- The treating team or helpline
- Two family members who can come quickly
What to carry
The latest reports and scan CDs, the endoscopy report, medicine strips, an ID card and any insurance or scheme card. Keep them in one folder by the door.
While you wait
What should the family do in the first few minutes?
Call first
Make the call before anything else. Say liver disease, say what you can see, and give a clear address with a landmark.
Keep them safe
If they are vomiting or drowsy, lay them on their side so they do not choke. Do not give food, water or any tablet unless the emergency team tells you to.
Pick up the folder
Take the sheet, the medicine list and the reports. Note roughly when the bleeding or confusion started.
Tell the treating team
Once the person is in hospital, let the oncology or liver team know. See what happens in hospital during a variceal bleed.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Commonly believed
What families often think in the moment
"It was only a little blood, let us wait till morning."
A small bleed from varices can be followed by a large one without warning. Any blood in vomit in someone with cirrhosis is a reason to go now.
"He is just sleepy because he is old and tired."
New drowsiness or muddled talk in liver disease is often hepatic encephalopathy, toxins reaching the brain. It is treatable, and it is often set off by a bleed or an infection that also needs treatment. See when confusion needs hospital admission.
"Black stools are from the iron tablets."
Iron can darken stools, but tarry, sticky, smelly black stools can mean bleeding. If you are unsure, treat it as bleeding and go. Read about black tarry stools.
"A fever is just a fever, paracetamol will do."
With fluid in the belly, fever or belly pain can mean the fluid is infected. That needs antibiotics in hospital the same day.
Being straight with you
What this page cannot tell you
It cannot tell you which hospital is right for your area, or which signs matter most for your relative. That depends on whether they have varices, fluid in the belly, past episodes of confusion, and what treatment they are on. Ask the treating doctor to go through the sheet with you once and add anything specific.
Who this does not apply to
If the liver cancer is small and the liver itself is healthy, with no cirrhosis, varices or fluid, most of these emergencies are unlikely. A general plan for fever during cancer treatment may suit you better. Ask your team which one fits.
What CION does and does not do
CION centres are outpatient cancer clinics. They do not run an emergency department, and endoscopy to stop a variceal bleed is done at partner hospitals. In an emergency, go to the nearest hospital with an emergency department first, then call the CION helpline so your team can share records and stay involved.
Update the sheet after every change in medicines or every new diagnosis, and date it.Questions we are asked
Common questions about a liver emergency plan
When should I call an ambulance for someone with liver cancer?
Call an ambulance now for vomiting blood or coffee-ground material, black tarry or bloody stools, fainting, or being cold, pale and breathless. Call one too if they are confused and cannot sit up safely. Say that they have liver disease when you call.
Should I take them to the CION centre in an emergency?
No. Go to the nearest hospital with an emergency department. A bleed or severe confusion needs emergency care, endoscopy and monitoring straight away. Once they are being treated, call the CION helpline so your oncology team can send records and stay involved.
Can I give water or food while waiting?
Not during a bleed or when the person is drowsy. They may need an endoscopy, and a drowsy person can choke. Lay them on their side and keep them still. Give nothing by mouth unless the emergency team says it is safe.
What if we live far from Hyderabad?
Go to the nearest hospital with an emergency department, not the one where treatment happens. Travelling a long way during a bleed is dangerous. Write the nearest suitable hospital on the sheet before you need it, and ask your team which local hospital can manage a variceal bleed.
Which medicines should be marked on the sheet?
Mark the beta-blocker that protects against bleeding, lactulose and any other medicine for confusion, water tablets, blood thinners, diabetes medicines and every cancer medicine. Emergency doctors make different choices once they know these. Never stop any of them on your own.
Should the plan be in Telugu?
Write it in whatever language every person in the house reads easily. Many families keep Telugu and English side by side, so a neighbour or a paramedic can also read it. Keep the warning signs short and in large print at the top.
How often should we update it?
Whenever a medicine changes, a new problem is found, or a new procedure is done, such as banding of varices. Date each version and throw the old one away, so nobody reads out a list that is no longer right.
Can CION help us write it?
Yes. Bring the latest reports and medicine strips to a visit, and your CION team can help you write the diagnosis, the medicines and the warning signs in plain words. Call the helpline if you are not sure what to include.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
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Patient stories
Hear it from people we have treated
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Sources
- NHS — Vomiting blood
- MedlinePlus — Bleeding esophageal varices
- Merck Manual Consumer Version — Hepatic Encephalopathy
- MedlinePlus — Peritonitis - spontaneous bacterial
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Vomiting blood: call an ambulance nowThe single most urgent sign on the sheet, explainedWhat happens in hospital during a variceal bleedSo the family knows what to expect after arrivalWhen confusion needs hospital admissionHow to tell drowsiness that can wait from drowsiness that cannotKeeping a single updated medicine listThe list that goes on the fridge beside this plan
Talk to us
Want help filling in the emergency sheet?
Bring the latest reports and medicine strips to your next visit. Your CION team can help you write the diagnosis, medicines and warning signs in plain words for the family. One helpline serves every CION centre.