Should You Go to the ER or Urgent Care?
How to know where to go for your pressing health care needs
All too often, illness or injury appear out of the blue: You wake up in the middle of the night with intense abdominal pain. You stumble while carrying groceries up a flight of stairs, and can no longer put weight on your swollen ankle. Or your baby spikes a high fever on the weekend.
When these situations occur, we’re often faced with uncertainty about where to go for care, especially if the symptoms seem severe and our regular doctor’s office is closed.
While the answer is not always simple, knowing the difference between urgent care and emergency care and where to seek treatment could save your life in a medical emergency.
The differences between urgent care and the emergency room
“Recognizing the differences between ‘emergency’ and ‘urgent’ care can be confusing, because both terms imply there is a medical need that needs to be addressed quickly,” says Shawn Evans, MD, an emergency medicine physician at Scripps Memorial Hospital La Jolla. “However, there are distinct differences between hospital emergency rooms and traditional urgent care centers, including the level of care that can be provided at each.”
Urgent care clinics help fill a vital gap when you become sick or injured, but your regular doctor is not available and you can’t wait for an appointment.
“If your sudden illness or injury is something you would normally feel comfortable addressing with your primary care doctor, then an urgent care setting is probably more appropriate than the emergency room,” says Dr. Evans.
Hospital emergency departments provide medical care at any time, day or night. However, unlike urgent care centers, they are equipped and staffed for even the most complex or critical needs, including life- and limb-threatening situations ranging from heart attack and stroke to traumatic injuries following a car accident.
Time for the ER
There are a number of medical conditions that are considered emergencies because they can require rapid or advanced treatments (such as surgery) that are only available in a hospital setting.
Symptoms that are best evaluated in an emergency room include:
- Persistent chest pain, especially if it radiates to your arm or jaw or is accompanied by sweating, vomiting or shortness of breath
- Difficulty breathing
- Any severe pain, particularly in the abdomen or starting halfway down the back
- Sudden clumsiness, loss of balance or fainting
- Sudden difficulty speaking, or trouble understanding speech
- Altered mental status or confusion, including suicidal thoughts
- Sudden weakness or paralysis, especially on one side of the face or body
- Severe heart palpitations
- Sudden, severe headache
- Sudden testicular pain and swelling
- Newborn baby with a fever (a baby less than three months old with a temperature of 100.4 degrees or higher needs to be seen right away)
- Falls that cause injury or occur while taking blood thinning medications
- Sudden vision changes, including blurred or double vision and full or partial vision loss
- Broken bones or dislocated joints
- Deep cuts that require stitches — especially on the face — or a large open wound that won’t stop bleeding
- Head or eye injuries
- Severe flu or cold symptoms
- High fevers or fevers with rash
- Vaginal bleeding during pregnancy
- Severe and persistent vomiting or diarrhea
- Serious burns
- Seizures without a previous diagnosis of epilepsy
“Trust your gut,” says Dr. Evans. “If your personal instinct or your motherly intuition tells you it’s serious, don’t hesitate — go to the nearest emergency room.”
When to call 911
Even if it is clear that you or your loved one needs emergency care, you may be unsure whether to drive yourself to an emergency room or call 911.
“Many people are nervous about calling 911, but it’s better to be safe than sorry,” says Dr. Evans. “You should never drive yourself if you are having severe chest pain or severe bleeding, if you feel like you might faint, or if your vision is impaired. When in doubt, please call 911 — what matters most is that you get to the emergency room quickly and safely.”
For certain medical emergencies such as a heart attack or stroke, calling 911 for an ambulance is always the right decision. This is because paramedics often can begin delivering life-saving treatment on the way to the hospital.
Urgent care is not emergency care
A study conducted by the National Center for Health Statistics found that among patients who had visited the emergency room but were not admitted to the hospital, 48 percent went there because their doctor’s office was not open.
“Many people use the ER as a place to receive after-hours care for minor illnesses or injuries without realizing they have another option,” says Dr. Evans.
Urgent care centers are same-day clinics that can handle a variety of medical problems that need to be treated right away, but are not considered true emergencies. Symptoms that can be evaluated and treated at an urgent care clinic include:
- Fever without rash
- Ear pain
- Painful urination
- Persistent diarrhea
- Sore throat
- Minor trauma such as a common sprain or shallow cut
If your symptoms come on gradually or you already know the diagnosis — for example, you have repeat urinary tract infections, or you recognize when your child has come down with an ear infection — it’s worth calling your primary care doctor’s office to see if you can get a same-day appointment. After all, your primary care doctor knows your health history, including what treatments have worked best in the past and whether you have other medical conditions that need to be taken into consideration.
However, while urgent care clinics are not a substitute for your primary care physician, they are a great resource when you need care but can’t get in with your doctor.
Be prepared for medical care
Whether you’re going to an urgent care clinic, the ER or your primary care physician’s office, it’s a good idea to bring a list of all the medications you take, including over-the-counter medicine, vitamins and supplements. This list should include how much of each medication you take as well as how often you take it.
Also keep with you a list of any allergies (including medication allergies) and any previous medical procedures or surgeries you’ve had. When listing procedures and surgeries, note the dates they were performed and the names of the physicians or surgeons who treated you.
“Especially in an emergency setting, it can be very helpful for the physician treating you to know whether you’ve had operations in the past, or whether you’re allergic to medications or anesthesia,” says Dr. Evans.
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