Emergency room or urgent care? How to know where to go.

Most of us know what to do in a medical emergency. Call 911 when someone is having a life-threatening health problem. Also call if they can’t get to the emergency room (ER) without an ambulance. We also know to call our primary care provider (PCP) about smaller things, such as: 

• Chronic conditions 
• Minor illnesses 
• Nagging symptoms 
• Medication issues   

But what about when it’s outside normal office hours and you’re in pain? Or if you need medical care fast?  

It can be hard to know whether some conditions or symptoms are life-threatening or not. Even if you know what’s wrong, you might wonder if you should head to the ER in the middle of the night. 

In most cases, your PCP should be your first call. It doesn’t matter what time it is. Emergency departments can be busy. They will always care for the most serious conditions first. If your PCP doesn’t send you to the ER, and you don’t think your condition is immediately life-threatening, find another place to get care. Making the right choice can save you time and money. 

Another option is an urgent care center. These are great for minor illnesses and injuries. It may make sense to visit an urgent care center if you have any of these symptoms: 

• Mild to moderate pain 
• Minor bleeding 
• Minor sprains or injuries 
• Trouble urinating 
• Minor upper respiratory symptoms 
• Simple X-rays 
• Sore throats, coughs, and fevers  
• Quick lab tests  

Still not sure where to go? Ask yourself the questions below to help you decide. 

1. What does my PCP say?  

You don’t have to decide where to go on your own. Many primary care offices let you talk to a physician even after hours. They are good to call because they already know your health history.  

Most PCPs have a phone recording that offers a way to reach the provider on call. Don’t be afraid to use it. Your question is the exact reason someone is on call. You can explain your symptoms and ask questions. The provider can tell you whether you should visit the ER or urgent care. They may also suggest waiting to see your usual provider. 

2. Is my life, a limb, an organ, or my health at serious risk?  

Maybe you can’t reach anyone at your PCP’s office. Or maybe you feel you need the ER right away. Answering “yes” to the above question means it’s time for emergency care. It’s known as the “prudent layperson standard,” says Bradley J. Uren, MD, an emergency medicine expert. 

It explains that if a person without medical knowledge believes their health is at risk without immediate care, they should consider it an emergency, says Dr. Uren. 

The ER is the best option when getting care quickly is important. Some of these symptoms include: 

• A bone out of place 
• A damaged limb 
• Facial drooping 
• Intense pain  
• Slurred speech  
• Weakness in an arm or leg 
• Difficulty breathing 
• Severe bleeding  
• Thoughts of harming yourself or others  
• Thoughts of attempting suicide 

If you are having a mental health crisis, you can call 988 to reach a trained crisis counselor at the 988 Suicide & Crisis Lifeline. You can also text 988. Or you can chat with a counselor at 988lifeline.org.  

If you think you may need surgery or have a broken bone, you may need the ER. Most other health concerns can be taken care of in urgent care or when your provider’s office can see you. 

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3. What conditions do I have? What am I at risk for? What have I been treated for in the past?  

These are important questions to think about before you’re in a possible emergency. Talk with your provider about them. During your next appointment, ask what conditions you may be at risk for and what symptoms to watch out for. Work with your provider to make a plan. Use this plan so you know what to do if you have mild but concerning symptoms. 

Symptoms don’t have to be severe to be an emergency. Say you can’t hold your phone normally. Hand weakness may seem small, but it’s a sign of a stroke. If it comes with other symptoms of a stroke, like slurred speech or face drooping, you need to head to the emergency room ASAP.  

On the other hand, some severe symptoms might not need emergency care. This may be the case if you’ve had them before. Take the symptoms of a panic attack. These include: 

• Chest pain 
• Difficulty breathing 
• Excessive sweating 

These symptoms are the same as a heart attack. This seems scary, but panic attacks usually aren’t dangerous. This is good to know if you get panic attacks often. It could save you a trip to the ER.  

What if you’re just not sure what your symptoms might mean? Call your provider or head to the ER. It’s always better to be safe than sorry.  

4. Are my symptoms getting worse?  

The start of symptoms might not tell you whether your condition is severe enough for the ER. If things get worse quickly, that can be a sign. Appendicitis is a good example. If it needs emergency surgery, you might have symptoms that worsen over hours or a few days. 

Ideally, you’ve already talked to someone at your PCP’s office about how to watch your condition. “When I talk to someone on the phone who is having shortness of breath, I can tell when it’s a big deal,” says family physician Jennifer L. Brull, MD. “If you can speak a full sentence without taking a breath, you might want to go to urgent care. But if it turns into gasping for breath every few words, then you need the emergency department.” 

5. What does my gut tell me?  

Don’t ignore the little voice inside you that says something serious is going on. If you can take a few minutes to call your physician’s office, do so. But also keep in mind that gut feelings may be another way to know you need the emergency room. “Nobody should ever delay emergency care if they believe their life, limbs, or organs are at risk,” says Dr. Brull.  

6. Am I prepared? 

Be sure to plan as much as possible. This is true for both the ER and urgent care. Bring your insurance card and a list of your medications and allergies.  

“We’ve been seeing a lot of platforms that help track your health history,” Dr. Brull says. Your health plan comes with the Wellframe app, a digital health management app that helps you store and share your medical history. When you’re not feeling well, these apps can help make sure you have all the important information, Dr. Brull adds. 

Article source: 
Prudent layperson standard: American College of Emergency Physicians