The ER or urgent care? How to know where to go when you get sick.
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During this visit, it’s a good time to discuss general aches, pains or if you’ve just “not been feeling right” for while. Your primary care doc will also screen you for mental health concerns such as anxiety and depression.
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Go to urgent care for those every day ailments – but not abdominal pain
Urgent care is a great option for those every day accidents and ailments. For example:
- A cut on the finger from chopping onions that may need stitches
- An ankle sprain after tripping over the leash while walking your dog that needs an X-ray
- Your child is tugging at his ears and you want to have a doc look in his ears
- An itchy rash after hiking in the woods
- A sore throat and fever
- One or both eyes are irritated, red, and have discharge
- A mild viral illness
In my experience, the one concern patients should always go to the ER for is abdominal pain. Abdominal pain is the most common reason for an ER visit because it’s so vague and can include appendicitis, kidney stones, an ectopic pregnancy, a heart attack, lower lobe pneumonia, a urinary tract infection or a hernia, to name a few.
The vast majority of abdominal pain patients are safely discharged from the ER without a firm diagnosis. So yes, a lot of these patients could be safely evaluated and treated in an urgent care setting. However, there’s just far too much that could be missed. An urgent care can run basic blood and urine tests, but the more dire causes of abdominal pain often need to be ruled out using CT or ultrasound imaging that not all urgent care clinics have immediate access to.
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When to call 911 or head to the ER
What is much clearer is that patients should call 911 or head to their nearest ED with the following.
Acute chest pain especially if it’s heavy in quality (elephant sitting on chest), associated with shortness of breath, sweating, and nausea or vomiting. “Time is heart,” we say, and the faster the patient can get to the ER, the more beneficial a heart-saving procedure known as a cardiac catheterization will be.
Symptoms of stroke. Act FAST is a good mnemonic device to remember if a family member looks like they’re having a stroke.
- F: Ask the person to smile. Is there a droop of the FACE on one side?
- A: Ask the person to put both ARMS out in front of them like they’re flying. Does one arm drift downwards?
- S: Ask the person to repeat simple phrase. Is their SPEECH slurred? Are they having difficulty speaking or does it not make sense?
- T: Note the TIME the symptoms started and call 911. This information will be important for the ER doctor.
One of the most commonly missed signs of stroke is severe dizziness. If a family member or friends is suddenly very dizzy with unsteady gait and falls to one side in particular, this could be a posterior circulation stroke.
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Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault and Twitter @MichaelDaignau3
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