A hernia strangulation is a catastrophic event and you will be very aware that you are in trouble and you need immediate help. When you feel that way go to the ER. If you have severe crampy abdominal pain in particular with nausea and vomiting lasting for more than two hours go to the ER. There is a federal law called EMTALA (Emergency Medical Treatment And Active Labor Act) which tells hospitals that they have to treat you. If you need immediate surgery they have surgeons on call that are obligated to do your surgery.