The Quick Answer: If it’s potentially life-threatening you should go to the ER. Read on for more information.
Knowing when to use an emergency department or an urgent care can be tough! Urgent care centers can provide care for everyday medical problems, while ERs are best equipped to handle life-threatening emergencies. Urgent cares are cheaper and often faster. Emergencies departments are more expensive, but provide have a greater range of testing capabilities and treatments. Emergency departments are also run by physicians and nurses with more training in emergency medical problems. So how is one supposed to choose? I’ve worked as an ER doctor for years and here are the factors I consider when trying to decide where to go.
Could your symptoms represent a life-threatening condition?
This question isn’t always easy to answer. In fact, it’s probably the reason you want to see a doctor, right?? While this is a hard question to answer, we should think about what’s most likely. A healthy young person with a cough and runny nose for 2 days is unlikely to be a life-threatening sickness while an older individual with 2 heart attacks in the past experiencing chest pain is concerning. If you think your symptoms could represent a life threatening or limb threatening emergency, the answer is clearly to go to the nearest emergency department. Examples of medical problems typically handled in urgent cares are: sore throat but can breathe and swallow, fevers in vaccinated children, sinus pain, ear pain, painful urination, minor or superficial cuts, sprains or muscle strains, etc. Obviously, there are exceptions to every rule, but usually these types of symptoms represent annoying-but-not-dangerous conditions.
What are your risk factors?
One very important factor to consider when deciding between and urgent care and ER is how healthy you are at baseline. The healthier you are to begin with, the more likely an urgent care can adequately care for you. Factors to think about include:
Age: The older you are, the more likely a sickness or injury is to be serious. As we humans age we develop more medical problems as our bodies slowly wear out. Bones become more brittle and reflexes slow. The elderly should be more likely to seek care in an emergency department. Whether it’s a fall, chest pain, shortness of breath, abdominal pain, fever, confusion or whatever. Another special age group is the very young. Babies less than 3 months, especially if born prematurely, can have all kinds of challenges and are at higher risk. If you’re worried about your very young baby, I’d choose an ER.
Smoking status: Folks who have been smoking for decades are greater risk or many problems including heart attacks, strokes, COPD and emphysema and multiple kinds of cancer. If you’re a long-time smoker, you’re at great risk of serious medical problems and should strongly consider going to an ER instead of urgent care.
Pregnancy: Pregnancy comes with a whole new set of potential conditions. In non-life-threatening emergencies try to coordinate carefully with your OBGYN. If the situation is more serious or rapidly evolving, seek the nearest ER. Examples of times to seek emergent care would be a seizure, heavy vaginal bleeding, you can no longer feel your baby moving, chest pain or shortness of breath.
Diabetes, obesity and other chronic medical conditions: Those who have underlying medical problems like obesity or diabetes are more likely to have serious medical problems. Diabetics may have a harder time with wound healing and fighting off infections. Those with obesity may be at greater risk of a serious injury with even minor falls. If you’ve got some long-standing health problems, lean more toward going to an ER. If you are young and otherwise healthy, think more about an urgent care.
What time of the day is it?
Most urgent cares aren’t open in the middle of the night, or on weekends or holidays. If you’re worried you have a time sensitive condition and the urgent cares are closed, don’t feel bad about going to an ER. If your condition isn’t likely to change much over the course of a few hours, is not likely to be life-threatening and your pain is tolerable, you can consider waiting until doctor’s office and urgent care centers open up in the morning.
Do you take blood thinners?
Blood thinners are an amazing medication for conditions like atrial fibrillation, where they can prevent strokes. The downside is that they are also more likely to cause bleeding after an injury. Even minor falls or traumatic accidents in individuals on blood thinners, especially the elderly or alcoholics, can cause bleeding in the head or elsewhere that can be very serious. If you take a blood thinner, you should most likely be seen in an emergency department for any falls or injuries.
Is this something that needs to be dealt with now, or can it wait?
When thinking about whether to go to an emergency department you’ll want to consider how time sensitive your condition is. Bleeding, open wounds, heart attacks, strokes, vision problems, severe pain are a few examples of the things that shouldn’t wait. Waiting can make things worse. On the other hand, some things aren’t made worse by waiting a few hours or even a few days. That knee that’s been bothering you for the past 6 months can probably wait until your doctor’s office opens up.
Is your problem a traumatic accident?
One key difference between most urgent care centers and emergency department is the availability of a CT scanner and ultrasound. CT scanners are very useful for detecting multiple serious conditions like appendicitis, internal bleeding or infections, blood clots in the lungs, some types of broken bones, and more. Ultrasound is another tool usually found in emergency departments in is excellent for checking for blood clots in the legs (DVTs), and gallbladder problems.
Obligatory Disclaimer:
This article provides general information only. It is not a substitute for professional medical advice, diagnosis, or treatment. Consult a healthcare provider for personalized guidance. Your reliance on this article is at your own risk.