As an emergency physician, I often receive “curbside consults” (informal requests for advice) from family and friends — a laceration to the hand during an oyster-shucking misadventure, persistent knee pain despite all the bravado during a jiu-jitsu competition, a child vomiting after a head injury. A common question in each scenario is “Should I go to the emergency room?”
Triage is an imperfect science. Serious medical conditions and benign illnesses share many of the same symptoms. For instance, a heart attack and acid reflux can both cause chest discomfort, and both a stroke and Bell’s palsy can manifest with a facial droop. The list goes on — enough to fill the curriculum of a four-year emergency medicine residency! Someone not trained in medicine may not always know whether to go to an urgent care clinic or an emergency room.
Here, I’ll attempt to share a simple process for deciding where to go the next time an unexpected health issue arises; it’s the same approach I use when guiding my family and friends. After a few questions about symptoms, deciding whether you should visit an urgent care center or go quickly to an emergency department is based on two variables: timing/urgency and the tools or resources you might need.
Although we’re often unprepared for emergencies, understanding where to seek medical assistance will help ensure that you receive the right level of care — also, knowing which concerns can be handled at an urgent care clinic will help keep emergency departments free to handle true emergencies, which benefits all of us.
There are many medical conditions that require clinical evaluation and management within 24 to 48 hours but that are not life- or limb-threatening and can be treated in a more patient-friendly environment — this is when urgent care can be a great choice. (Read “Urgent Care: What Is It and What Should I Expect?” to learn more about urgent care clinics and how they can help you.)
Conditions commonly treated in an urgent care clinic include:
• Musculoskeletal injuries, such as simple fractures or bad sprains
• Soft tissue injuries, such as lacerations or wounds
• Upper respiratory infections, such as bronchitis or sinusitis
• Ear infections
• Sexually transmitted infections
From the physician’s perspective, I think about the diagnostic and management resources we have available in each care setting. This can also help patients make an informed decision about which type of care they may need.
For urgent care, this typically includes:
• A thorough history and physical examination
• Point-of-care tests
• Electrocardiograms (ECGs)
• Point-of-care ultrasounds
• Blood draw for outpatient labs
• Procedures such as splinting for simple types of fractures, incision and drainage of abscesses, and suturing and wound care for many lacerations.
Generally, urgent care clinics are staffed by physicians with specialty training in family medicine or emergency medicine, or by advanced practice clinicians (physician assistants and/or nurse practitioners) with prior family medicine, urgent care, or emergency medicine experience.
There are certain medical conditions that require immediate evaluation. such as heart attacks, strokes, severe trauma, and severe infections (sepsis). There are also symptoms based on your risk profile that require evaluation within six hours and access to a broader set of diagnostic tools than what is available in most urgent care settings. This might include chest pain in patients older than 40 or shortness of breath in patients with underlying chronic diseases.
Common conditions treated in an emergency room include:
• Chest pain, especially in patients with risk factors such as older age, high blood pressure, high cholesterol, diabetes, and family history of heart issues
• Trouble breathing, especially if the patient is having difficulty with normal activities
• Abdominal pain, especially in patients with risk factors such as older age
• Weakness on one side of the body
• Head injuries or severe trauma
Resources available at most emergency departments include:
• A broader set of labs with most turnaround times within one hour
• Comprehensive ultrasounds
• Advanced imaging, such as CT scans
• Access to specialty consultations for urgent needs
• Access to inpatient care if hospitalization is required
For many acute (new) conditions that require a clinical evaluation and management within 24 to 48 hours, a visit to an urgent care clinic — where there is access to a qualified provider, point-of-care tests, X-rays, and certain procedures — may be a good start. In some instances, your provider at the urgent care clinic may recommend an evaluation in an emergency department, based on your risk profile.
For higher-risk symptoms that require attention within six hours and access to advanced imaging, urgent specialty consultations, or hospitalization, a hospital emergency department is more appropriate.
I hope this helps clarify the capabilities and limitations of urgent care and emergency care. At Carbon Health, our providers are standing by to provide urgent care services both in-person and virtually, with same-day appointments, walk-in availability, and evening and weekend accessibility. Learn more about Carbon Health.
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