How to know where to go for sudden health care needs
All too often, illness or injury appears out of the blue: You wake up in the middle of the night with intense abdominal pain. You stumble while carrying groceries up a flight of stairs, and can no longer put weight on your swollen ankle. Or your baby spikes a high fever on the weekend.
When these situations occur, we’re often faced with uncertainty about where to go for care, especially if the symptoms seem severe and our regular doctor’s office is closed.
While the answer is not always simple, knowing the difference between walk-in clinics, urgent care and emergency care and where to seek treatment could save your life in a medical emergency.
The differences between walk-in clinics, urgent care and the emergency room
“Recognizing the differences between ‘emergency’ and ‘urgent’ care can be confusing, because both terms imply there is a medical need that needs to be addressed quickly,” says Shawn Evans, MD, an emergency medicine physician at Scripps Memorial Hospital La Jolla. “However, there are distinct differences between hospital emergency rooms, traditional urgent care centers or walk-in clinics, including the level of care that can be provided at each.”
Urgent care or walk-in clinics help fill a vital gap when you become sick or injured, but your regular doctor is not available and you can’t wait for an appointment.
“If your sudden illness or injury is something you would normally feel comfortable addressing with your primary care doctor, then an urgent care center or walk-in clinic setting is probably more appropriate than the emergency room,” says Dr. Evans.
Hospital emergency departments provide medical care at any time, day or night. However, unlike urgent care centers or walk-in clinics, they are equipped and staffed for even the most complex or critical needs, including life- and limb-threatening situations ranging from heart attack and stroke to traumatic injuries following a car accident.
When to go to the ER
There are a number of medical conditions that are considered emergencies because they can require rapid or advanced treatments (such as surgery) that are only available in a hospital setting.
Symptoms that are best evaluated in an emergency room include:
- Chest pain or difficulty breathing
- Weakness/numbness on one side
- Slurred speech
- Fainting/change in mental state
- Serious burns
- Head or eye injury
- Concussion/confusion
- Broken bones and dislocated joints
- Fever with a rash
- Seizures
- Severe cuts that may require stitches
- Facial lacerations
- Severe cold or flu symptoms
- Vaginal bleeding with pregnancy
“Trust your gut,” says Dr. Evans. “If your personal instinct or your motherly intuition tells you it’s serious, don’t hesitate — go to the nearest emergency room.”
When to call 911
Even if it is clear that you or your loved one needs emergency care, you may be unsure whether to drive yourself to an emergency room or call 911.
“Many people are nervous about calling 911, but it’s better to be safe than sorry,” says Dr. Evans. “You should never drive yourself if you are having severe chest pain or severe bleeding, if you feel like you might faint or if your vision is impaired. When in doubt, please call 911 — what matters most is that you get to the emergency room quickly and safely.”
For certain medical emergencies such as a heart attack or stroke, calling 911 for an ambulance is always the right decision. This is because paramedics often can begin delivering life-saving treatment on the way to the hospital.
When to go to urgent care
Urgent care is not emergency care. A study conducted by the National Center for Health Statistics found that among patients who had visited the emergency room but were not admitted to the hospital, 48 percent went there because their doctor’s office was not open.
“Many people use the ER as a place to receive after-hours care for minor illnesses or injuries without realizing they have another option,” says Dr. Evans.
Urgent care centers are same-day clinics that can handle a variety of medical problems that need to be treated right away, but are not considered true emergencies. Symptoms that can be evaluated and treated at an urgent care clinic include:
- Fever without a rash
- Vomiting or persistent diarrhea
- Abdominal pain
- Wheezing or shortness of breath
- Dehydration
- Moderate flu-like symptoms
- Sprains and strains
- Small cuts that may require stitches
If your symptoms come on gradually or you already know the diagnosis — for example, you have repeat urinary tract infections, or you recognize when your child has come down with an ear infection — it’s worth calling your primary care doctor’s office to see if you can get a same-day appointment. After all, your primary care doctor knows your health history, including what treatments have worked best in the past and whether you have other medical conditions that need to be taken into consideration.
However, while urgent care clinics are not a substitute for your primary care physician, they are a great resource when you need care but can’t get in with your doctor.
Scripps offers urgent care services for children and adults — seven days a week — in Vista, Rancho Bernardo and Torrey Pines.
When to go to a walk-in clinic
Walk-in clinics (commonly referred to as a retail clinic) offer fast, convenient access to medical care. No appointment is necessary and they are generally staffed by nurse practitioners and physician assistants.
Walk-in clinics, including Scripps HealthExpress, address the most minor of ailments, such as:
- Painful urination
- Rashes without fever
- Mild flu-like symptoms
- Cough and congestion symptoms
- Sore throat
- Ear pain
- Eye redness, discharge or itchiness
They also provide additional services such as sports, camp and school physicals, and vaccines. They are a good option for when you are not feeling well, but it’s not serious enough for the emergency room or urgent care.
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