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When to choose urgent care or emergency room

Diseases and IllnessesLifeBridge HealthPneumoniaSinai Hospital in Baltimore

It's the weekend or nighttime, and someone in the family doesn't feel well or has hurt themselves. Many people assume the local hospital's emergency department is the best place to go for treatment, but an urgent care center may be a faster and cheaper way to get care for less serious conditions, according to Dr. William P. Jaquis, chief of emergency medicine at Sinai Hospital of Baltimore. LifeBridge Health, Sinai's parent company has recently partnered with ExpressCare urgent care centers.

What is the different between the local hospital's emergency department and an urgent care center?

An emergency department (ED) is an area of a hospital that is prepared to treat people who need immediate medical attention for serious traumas, sudden illnesses and other health-related emergencies. An urgent care center is ready to treat the less serious, more everyday ailments and conditions that also need prompt care from skilled clinicians.

People do not need to make appointments at either an ED or urgent care center; they can just walk right in and be seen. Emergency departments are open 24 hours a day, seven days a week, and while urgent care centers are not generally open around the clock, they are staffed beyond the hours of most primary-care practices and include evening and weekend hours. In addition, they are also located in the communities of the people who need the help, so they are very convenient.

What maladies are best cared for by each?

A good rule of thumb is the sicker people are, the quicker they should get to an emergency department. By contrast, the healthier they are, the better the choice an urgent care center can be. Urgent care centers are often equipped to treat the following and similar conditions: coughs and colds; ear infections; rashes' strep throat; pink eye; sinus infections; pneumonia, urinary tract infections; yeast infections; painful urination; nausea/vomiting; lacerations; minor burns; mild dehydration; persistent diarrhea; sprains and broken bones; and animal bites.

However, there are clear cases when an individual should head straight to the nearest emergency department. They include the following symptoms: chest pain, dizziness/ lightheadedness; shortness of breath; a major injury; a high fever with other illnesses, such as a heart or lung condition; signs of a stroke, such as sudden facial paralysis, numbness or weakness in the face, arm or leg (especially on one side), slurred speech or an altered mental state; impaired vision; head trauma; loss of consciousness; severe abdominal pain; and profuse bleeding

Are there conditions that could make it confusing as to whether an ED or an urgent care center is the better choice?

If in doubt, go to an ED because it's better to be safe than sorry, and doctors could lose valuable time helping someone who is first at an urgent care center and then must be transferred to an ED. However, here are some examples of the same incident with different outcomes:

A woman is crossing the street and steps into a pothole, twisting her ankle. If the ankle swells up and is uncomfortable, going to an urgent care center would probably be a good choice for her. If, however, the ankle looks deformed or if she can see the bone, an ED would definitely be the way to go.

If a man is in a minor car accident and the impact is minimal, he might want to go to an urgent care center to be checked out. However, if he lost consciousness or had trouble moving any part of his body, even for a short time, he would want to be taken directly to an emergency department.

Can urgent care centers handle pediatric, geriatric and other special cases?

Urgent care centers can treat children and the elderly in many circumstances for the same minor illnesses and conditions for which teens and adults are treated. However, infants who are 8 weeks old or younger and elders who are extremely frail should go straight to an emergency department.

When is it OK to wait to go to your family doctor?

If a person has any of the conditions mentioned earlier in the "must go directly to the ED" list, that person should still go immediately to the ED.

Going to an urgent care center for minor injuries/ illnesses can be a wise decision because spending hours in pain and discomfort until a doctor's office opens in the morning may not be the best idea for some people. Also, with many primary care practices being so busy, it's not always easy to get an appointment the next day, so each individual should know how things work to make an informed conclusion. However, the comfort of seeing one's own doctor should not be discounted either.

Is it best to stick with urgent care centers and hospitals affiliated with your family practice or are there more important factors in choosing a facility?

It can be better to go to a center affiliated with someone's own doctor because there is a continuum of care that the medical professionals within an affiliated health care network have with each other. They also have quick access to a patient's information, history and test results. However, balance that ease with how quickly a condition needs to be treated.

I'd also like to mention that in the past, there have been questions raised whether a person needed to go to an ED when an urgent care center could have sufficed. However, don't take chances with health matters if there is any question that the situation is dangerous.

meredith.cohn@baltsun.com

Copyright © 2014, The Baltimore Sun
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Diseases and IllnessesLifeBridge HealthPneumoniaSinai Hospital in Baltimore
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