The hospital emergency room is where you need to be if you have a life-threatening emergency. The doctors, nurses, medical assistants and technicians are specially trained to deal with critical problems that can mean life or death. But all too frequently, they’re also the first place people think of when they’re sick. In addition to people brought in by ambulance, ER waiting rooms are filled with those who might have the flu, need a med refill or just don’t feel well, all non-life-threatening illnesses. So how do you tell whether you should go to the emergency room, an urgent care center or just wait until your doctor’s office is open? NOTE: This article is not a substitute for your best judgment. If you feel you have a true emergency, CALL 9-1-1.
The doctor’s office
Your doctor’s office should always be your first stop for non-life-threatening illness. If you feel like you have the flu, your child is sick with a temperature under 101, or someone in the house just doesn’t feel well, the first thing to do is call your doctor’s office or your health insurance Ask-A-Nurse line. Describe what’s going on in detail and they’ll let you know whether you need an appointment, need more urgent care or just need to take an aspirin or Tums and see what happens.
Urgent care centers
According to a recent survey conducted by the National Center for Health Statistics, 48-percent of those going to the hospital emergency room went because their doctor’s office was closed or they had no health insurance. Enter urgent care centers. Urgent care centers are springing up all over the country, from walk-in clinics at your local grocery store or pharmacy to former store fronts and formerly empty corners. Typically, urgent care centers are open when your doctor’s office isn’t, or when you can’t get an appointment, some open 24/7, others closing at seven or eight at night. They offer the benefit of being seen more quickly than going to the ER. Most are connected to major medical centers close by, so if they feel you need to be seen in the ER, you can easily be transferred.
Urgent care centers are staffed by qualified doctors, nurses, medical assistants and technicians, the same as an ER, and the stand-alone centers often have imaging and blood test capabilities right on site.
When should you go to an urgent care? If you or your child are experiencing:
- Fever no higher than 102 without a rash or altered thinking
- A fever that’s under 102 but has lasted more than a day
- Minor trauma, such as a sprain, strain or cut where it’s questionable if you need stitches
- It’s painful to go to the bathroom
- Persistent diarrhea or vomiting
- Severe sore throat
- Persistent cough
- Other non-urgent or questionable illness or injury
Urgent care is also a great place to go if you have no health insurance. Most will offer payment plans or give you a discount if you can pay on the spot.
The hospital emergency room
These days, when you go into the hospital emergency room as a walk-in, you’re greeted by a waiting room filled with people suffering from everything from a broken leg to a cough or fever. Increasingly, ERs are being used as a substitute for going to the doctor’s office, especially for those without insurance, taking resources away from those who need help most urgently.
Hospital emergency rooms don’t run on a first-come-first-served basis. They perform what is called a “triage;” each patient coming in is assessed for what the problem is and the most critical are taken first. The result is as much as a four-hour wait if you’re in because you’re not sure if you have the flu or not.
The emergency room is definitely your first line of care if you or your loved one are experiencing:
- Persistent chest pain, especially if it radiates to your arm or jaw or is accompanied by sweating, vomiting or shortness of breath
- Persistent shortness of breath or wheezing
- Severe pain, especially in the abdomen or starting halfway down the back
- Loss of balance or fainting
- Difficulty speaking, altered mental status or confusion
- Weakness or paralysis
- Severe or recurring heart palpitations
- Sudden, severe headache
- Sudden testicular pain and swelling
- Newborn baby with a fever
- Intestinal bleeding
- Falls with injury or while taking blood thinning medications
- Loss of vision
- Head and eye injuries
- Broken bones or dislocated joints
- Deep cuts that require stitches – especially on the face
- Head or eye injuries
- High fevers or fevers with rash
- Bleeding that won’t stop or a large open wound
- Vaginal bleeding with pregnancy
- Repeated vomiting
- Serious burns
- Seizures without a previous diagnosis of epilepsy
This, obviously, is not a definitive list, but it gives you an idea of what tpes of things would need attention in an ER. CALL 9-1-1 if you feel it’s a true emergency.
In any case, whether you’re just not feeling “right” or you’ve been in accident, get the medical care you need; just make sure it’s the right care.