Should I Go to Urgent Care or the Emergency Room?

Author: Kadeer Halimi, MD
Specialty: Emergency Medicine

I hurt my arm and the swelling won’t go down. … It’s the middle of the night and my baby has a fever. … My persistent cough has kept me up all night. … Where should I go?

When faced with sudden injury or illness, one typically weighs whether to seek treatment via urgent care or the emergency room. While they each fill a specific health care need, there’s enough overlap that deciding where to go to get the care you require is anything but simple.

So, what’s the difference between urgent care and emergency room care?

Think of urgent care as an extension of your primary care provider.

These walk-in clinics provide the acute medical care outside of normal office hours. It’s a great option when you can’t get an appointment with your regular doctor, can’t wait to be treated, or just need the convenience of evening and weekend hours. Urgent care is perfect for the types of injuries and illnesses like earaches, sprains or lingering cold symptoms – things that you’d typically see your doctor for. When used for appropriate ailments, an urgent care visit is generally less expensive than emergency room care.

Go to the emergency room for anything else.

As the name implies, the ER is for emergencies. Open 24 hours a day and equipped to treat everything from minor illnesses to major injuries, you will receive the care you need. Because emergency rooms are set up to see patients based on severity of injury or illness rather than on a first-come, first-served basis, they’re most effectively used to treat life-threatening conditions like heart attack, stroke, and major injuries – conditions that may require advanced diagnostics like ultrasounds, CT scans or MRIs; specialist intervention; operating rooms; or overnight stays. In addition, you cannot be denied care in an emergency room as they’re legally required to treat anyone who comes through its doors.

Is this an emergency?

While there’s no hard and fast rule of thumb, there are some considerations that can help guide your decision to seek emergency care. In a true emergency situation, immediate intervention is required to prevent death or disability for you, your loved one or your unborn baby.

Call 911 if you or your loved one experiences any of the following symptoms or situations:

• Head injury that causes loss of consciousness and/or confusion
• Injury to the neck or spine
• Severe chest pain or pressure
• Signs of stroke, which include sudden facial drooping, weakness or slurred speech
• Seizure that lasts more than three minutes
• Choking or arrested breathing
• Severe burn
• Electric shock

Otherwise, go to the ER for:

• Complications of a known condition
• Persistent high fever
• Broken bones, deep wounds and serious burns
• Severe pain
• Heavy bleeding
• Trouble breathing
• Passing out, fainting and seizures
• Uncontrolled vomiting and diarrhea that lasts more than four hours
• Allergic reactions that cause hives, trouble breathing, or swelling
• Overdose, poisoning, or exposure to smoke or fumes
• Coughing or throwing up blood
• Mental health crises, specifically suicidal thoughts or actions

Or if you’re experiencing symptoms of a life-threatening condition, such as:

• Pain in the arm or jaw
• Unusual sudden, severe headaches
• Inability to speak, see or walk
• High fever with headache and stiff neck

Remember that calling 911 may be the best option for life-threatening emergencies, as paramedics can begin treatment in the field and can alert the emergency room of your arrival. This is true when you have symptoms of a life-threatening emergency and are alone or when an emergency room is not nearby.

Ultimately, you know your body best.

Seek emergency care when you feel you need it. For infants, young children, and the elderly, always err on the side of caution. In a true emergency, time is of the essence; it’s better to have the care and resources needed now than live with regret later.

Posted September, 2018

About Kadeer Halimi, MD
Dr. Kadeer Halimi is a board-certified emergency medicine specialist at Washington Hospital Healthcare System. In his role, he sees patients for everything from injury to illness. His best advice for people who are debating whether or not to go to the Emergency Room? “You know your body better than anyone else, so listen to it! If you think something may be wrong, it’s better to get help now than live with a lifetime of regret.”

Dr. Halimi earned his medical degree from Western University of Health Services, College of Osteopathic Medicine in Pomona, California, and completed his residency in emergency medicine at the Scott and White Hospital at Texas A&M in Temple, Texas. He is currently the Medical Director of the Washington Hospital Emergency Department, as well as Chair-Elect of the Washington Hospital Department of Medicine and Co-Chair of the Clinical Operations Re-Admissions Committee.