Should I Go to the ER or Urgent Care?

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Understand your options before illness or injury strikes.

It’s a Sunday afternoon, and you haven’t moved from your couch, convinced you have a life-threatening form of the flu. Or it’s Friday night and your boisterous boy just fell off the top bunk. Now he’s howling in pain with a bump on his head.

Why do these things always happen on weekends or after hours?

When illness or injury strikes, do you know if you need emergency or urgent care?

ER or urgent care?

Urgent care is an extension of your family doctor, with added perks such as X-ray, IV fluids, a lab, and in some centers, imaging. “Although urgent care centers can treat most situations, a huge percentage of people still default to the ER, which is for more severe cases,” says Dr. Alberto Jacir, a UHealth family medicine expert.

“Urgent care is convenient, efficient, and cost-effective,” Dr. Jacir says. The centers have extended hours, so you don’t have to interrupt your work day. Second, their staff can efficiently stabilize conditions such as fevers, bleeding, and some broken bones before sending you to the ER or orthopedist.

As far as cost, urgent care wins, hands down.

“An urgent care visit averages $153. An ER visit averages $1,700,” says Dr. Jacir.

If an illness or injury is something you would normally take to your family doctor, urgent care is a good choice.  For example, if your daughter routinely comes down with a cold when school starts, urgent care is an option.

“If you develop a fever and cough during flu season, keep hydrated, stay home from work or school, and see a doctor within 48 hours,” says Dr. Jacir. “Tamiflu, an antiviral medicine, is only effective within 48 hours of coming down with the flu. This is vital for children, the elderly, and people with heart or pulmonary disease.”

Other conditions treated at urgent care centers include:

  • Ear pain
  • Painful urination
  • Severe, ongoing diarrhea or vomiting
  • A sore throat
  • Common sprains or shallow cuts
  • First degree burns
  • Ankle, wrist, elbow, clavicle injuries – can be X-rayed and splint then sent to an orthopedist for follow-up

When to head to the ER

Some situations require immediate treatment. If your injury meets the following criteria, Dr. Jacir says go to the ER:

Second and third-degree burns
A bubble around a burn is serious. Burns in joint creases where your elbows or hands bend also need emergency care, as do facial burns.

Bleeding
Bleeding that does not stop with local pressure should be treated in the ER, but scalp wounds usually heal easily.

Wounds
Any cut beyond the skin into a muscle or tendon requires emergency surgery, as do large open wounds. Facial wounds also require emergency care.

Broken bones and dislocated joints
Some breaks heal without surgery, but if you see a significant deformity or protruding bone, go to the ER.

Head injuries
Kids and teens need a neurological evaluation in the ER and evaluation by a doctor for a few days afterward to rule out concussion. Urgent care centers can evaluate adults to see if they need the ER.

Other conditions requiring emergency intervention include:

  • Ongoing chest pain, especially if spreading to the arm or jaw or pain combined with sweating, vomiting or shortness of breath
  • Trouble breathing
  • Extreme pain in the stomach or middle back
  • Severe heart palpitations
  • Sudden, severe headache
  • Fainting, clumsiness or unsteadiness that comes on rapidly
  • Difficulty speaking or understanding speech
  • Weakness or paralysis, especially on one side of the face or body
  • Sudden testicular pain and swelling
  • Mental confusion, including suicidal thoughts
  • Injuries from a fall or while taking blood thinners
  • Rapid vision changes: blurred or double vision, complete or partial vision loss
  • Head or eye injuries
  • Fever with rash
  • Vaginal bleeding during pregnancy
  • Seizures with no history of epilepsy

When to call 9-1-1

If you’re not sure you can drive safely to the hospital or if you or another person suddenly experience serious symptoms, call 9-1-1. If your baby or child develops a fever and becomes “floppy” or lethargic, call 9-1-1.

University of Miami Health System has hospitalswalk-in clinics, and urgent care centers  throughout South Florida. Call 305-243-4000 or 1-877-243-4340 for information. Always dial 9-1-1 in an emergency.

 


By Nancy Moreland, contributor to UMiami Health News


 

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