Urgent Care vs. Emergency Room

For those who may not know, I currently work in an urgent care. I see people in my 12 hour shifts for various reasons. Some common things are coughs, ear pain, cuts that need stitches, burning with urination and sprains or broken bones. But every day I also see people who need more care than I can provide. I then send them to the emergency room (ER, we also call it the ED for emergency department).

Its hard to know: where should I go when I’m sick or in pain? Basically it breaks down to: what could you die from tonight? I know – that sounds brutal! But its seriously how every acute medical provider thinks. I want to know that when you leave my urgent care you’ll be safe until you can follow up with your primary care practitioner. If you might not be safe – its time to go to the ED.

Does your problem interfere with your heart, breathing or is it a possible surgical emergency? Can you go home for the next 12 hours and be totally safe? If not – this is a case for the ED. Possible Blood clots, chest pain, severe abdominal pain – all appropriate for the ED. Our emergency room is also the only place that does blood work. So lots of times patients need a blood workup – it’s a case for the emergency room. This happens with chest pain (we test for Troponins, a **protein** released when Cardiac tissue dies), possible Sepsis (we test for bacteria in blood and/or huge amounts of white blood cells), or maybe pancreatitis (we look for a large amount of an enzyme called Lipase).

We also think about who the patient is: is it a small baby, a medically fragile person or elderly adult? If so – just head to the ER. These people need extra workup, likely need blood work and are much more likely to be admitted.

Another reason to go to the ED is if or when a person is suicidal or homicidal. The official terms for this is “Is the person a danger to themselves or other people?” This is a tough area to discuss but its most definitely an emergency. Medical providers can place a patient on a 72 hour emergency notice.

So urgent care is appropriate for bothersome, nuisance, or things that can wait 12 hours. Think upper respiratory infections, ankle sprains and urinary tract infections. Also, ask what imaging your urgent care has. Do you need an x-ray? Does your urgent care offer X-rays? It sounds like common sense but you’d be surprised. Its tough to know what imaging you might need but try calling ahead. Your local friendly urgent care can likely give you a good idea if it’s an appropriate visit.

This is a super quick overview – but the bottom line is: ask yourself – can this wait 12 hours?

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