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Emergency room or urgent care?

March 05, 2015 | Heather Shannon
Urgent care service

It’s Friday night. While you chop an onion, your extra-sharp knife slips and now you have a nasty wound that’s bleeding profusely.

You need some help soon, but you’re unsure of where to go for assistance. Is this is a problem for the emergency room or urgent care?

Dr. Carl Schultz, an emergency medicine physician at UC Irvine Health, has an answer. “In general, emergency rooms are for when you don’t know what’s going on or when you think you may have a serious condition.”

In other words, your knife wound could likely be handled by your nearest urgent care center.

When to visit the ER

Schultz urges patients who are experiencing troubling symptoms with no obvious cause to head straight to the emergency room.

“When you have a very severe headache, abdominal pain, chest pain – those are things that are harder for urgent care to diagnose,” says Schultz. “Those are things that should be seen in the ER.”

Medical emergencies that should be seen in the emergency room include:

  • Severe heart palpitations
  • Loss of vision
  • Head and eye injuries
  • Broken bones
  • Persistent vomiting
  • Severe burns
  • Unexplained seizures
  • Vaginal bleeding while pregnant
  • Severe abdominal pain
  • Fevers with rash

Schultz’s guideline is simple: “When in doubt, go to the ER.”

If your symptoms involve more sinister symptoms – such as shortness of breath, chest pain, pain in the left arm, sudden weakness, numbness, slurred speech, severe headache or a limb-threatening injury – call 911 instead of attempting to drive to the ER, Schultz says.

When to go to urgent care

Urgent care, on the other hand, exists to treat non-life threatening medical problems that can’t wait until the next day.

Dr. D. Sajee Lekawa, an internist at UC Irvine Health offices in Tustin, says, “If you have lacerations and just need sutures, have a low fever or a urinary tract infection, come to urgent care. Don’t go to urgent care if you think you’re having a heart attack.”

Symptoms that can be treated in an urgent care setting include:

  • Fever
  • Minor traumas, such as sprains and bruises
  • Diarrhea
  • Vomiting
  • Pain with urination
  • Minor fractures of the hands or feet

If your symptoms are coming on gradually, or they are related to a chronic medical condition you have, try to see your primary care physician if available. 

Two of the major advantages of urgent care, says Lekawa, are that copays are generally cheaper than emergency care, and you usually can be seen more quickly than in an emergency room.

“If you have a urinary tract infection and you go to the ER, you could sit there for hours in discomfort before someone sees you,” Lekawa says.

ER and urgent care limitations

Both emergency rooms and urgent care clinics are limited in the services they can provide when you show up on their doorsteps.

In the emergency room, Schultz says a common misconception is that all medical problems can be solved there.

 “Often, we don’t find what the problem is, but we can tell you what you don’t have and that is it safe to go home and be evaluated by other doctors as an outpatient,” he says. “But we’re not dermatologists or gastroenterologists. We can’t meet that expectation.”

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