Emergency room or urgent care? How to know where to go.
Sometimes an emergency is obvious — but not always. Use these 6 questions to help make the best decision about where to go for your care.
Most of us know what to do in a medical emergency. Call 911 when someone is having a serious life-threatening health problem. Or call if they can’t get to the emergency room (ER) without an ambulance. We also know to call our doctor about other things such as:
- Chronic conditions
- Minor illnesses
- Nagging symptoms
But what about when it’s outside normal office hours and you’re in pain? Or if you need care fast?
“It can be hard for patients to know whether some conditions or symptoms are life-threatening or not,” says Jennifer L. Brull, MD. She’s a family physician in Plainville, Kansas. She’s also on the board of the American Academy of Family Physicians. Even if you know what’s wrong, you might wonder if you should head to the ER in the middle of the night.
First, some rules of thumb. In most cases, your primary care provider (PCP) should be your first call. It doesn’t matter what time it is. Emergency departments can be busy. They will always care for the most serious conditions first. If your PCP doesn’t send you to the ER, and you don’t think your condition is immediately life-threatening, find another place to get care. Making the right choice can save you time and money.
Where should you go if you can’t get into your PCP’s office? Or if it’s not a clear emergency? Take advantage of your plan's nurse advice line. You can talk to a registered nurse at any time — 24 hours a day, 7 days a week, 365 days a year. They can answer your questions and help guide you to the right care. And it’s at no extra cost to you.
Another option is an urgent care center. These are great for minor illnesses and injuries, says Bradley J. Uren, MD. He's an associate professor of emergency medicine at the University of Michigan Medical School in Ann Arbor. He says these symptoms are good reasons to visit an urgent care center:
- Mild to moderate pain
- Minor bleeding
- Minor sprains or injuries
- Trouble urinating
- Minor upper respiratory symptoms
- Simple X-rays
- Sore throats, coughs, and fevers
- Quick lab tests
Still not sure where to go? Ask yourself the questions below to help you decide.
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1. What does my PCP say?
You don’t have to decide where to go on your own. “Almost all primary care offices let you talk to a physician even after hours,” Dr. Brull says. They are good to check with because they already know your health history.
Most PCPs have a phone recording that offers a way to reach the provider on call. Don’t be afraid to use it. Your question is the exact reason someone is on call. You can explain your symptoms. And you can ask questions. The provider can tell you whether you should visit the ER or urgent care. They may also suggest waiting to see your usual doctor.
2. Is my life, a limb, an organ, or my health at serious risk?
Say you can’t reach anyone at your PCP’s office. Or maybe you feel you need the ER right away. Answering “yes” to the above question means it’s time for emergency care. It’s known as the “prudent layperson standard,” Dr. Uren says.
It explains that if a person without medical knowledge believes their health is at risk without immediate care, they should consider it an emergency, says Dr. Uren.
There are rules to regulate the way some insurance decisions are made about emergency care coverage. Chest pain is a good example. It can be caused by many conditions. Many are not life-threatening. But chest pain is also a symptom of a heart attack. And this can cause serious injury or even death, Dr. Uren says. The ER must check if you have chest pain.
The ER is the best option when getting care quickly is important. Some of these symptoms include:
- Bone is out of place
- Damaged limb
- Facial drooping
- Intense pain
- Slurred speech
- Weakness in an arm or a leg
- Severe bleeding
- Thoughts of harming yourself or others
- Thoughts of attempting suicide
If you are having a mental health crisis, you can call 988 to reach a trained crisis counselor at the 988 Suicide & Crisis Lifeline. You can also text 988. Or you can chat with a counselor at 988lifeline.org.
If you think you may need surgery or have a broken bone, you may end up in the ER too, Dr. Brull says. Most other stuff can be taken care of in urgent care. Or when your doctor’s office can see you.
3. What conditions do I have? What am I at risk for? What have I been treated for in the past?
These are important questions to think about before you are in a possible emergency. Talk with your doctor about them too. During your next appointment, ask what conditions you may be at risk of getting. And see what symptoms to watch out for. Work with your doctor to come up with a plan. And use this plan so you know what to do if you have mild but concerning symptoms.
Symptoms don’t have to be severe to be an emergency, Dr. Uren says. Say you can’t hold your phone normally. Hand weakness may seem small. But it’s a sign of a stroke. And if it comes with other symptoms of a stroke, like slurred speech or face drooping, you need to head to the emergency room ASAP.
On the other hand, some severe symptoms might not need emergency care. This may be the case if you’ve had them before. Take the symptoms of a panic attack. These include:
- Chest pain
- Shortness of breath
- Sweating
These symptoms are the same as a heart attack. This seems scary. But panic attacks aren’t dangerous. This is good to know if you have anxiety and get panic attacks often. It could save you a trip to the ER.
What if you’re just not sure what your symptoms might mean? Call your doctor or head to the ER. It’s always better to be safe than sorry.
4. Are my symptoms getting worse?
The start of symptoms might not tell you whether your condition is severe enough for the ER, Dr. Uren says. But if things get worse quickly, that can be a sign. Appendicitis is a good example. If it requires emergency surgery, you might have symptoms that worsen over hours or a few days, Dr. Uren says.
Ideally, you’ve already talked to someone at your PCP’s office about how to watch your condition. “When I talk to someone on the phone who is having shortness of breath, I can tell when it’s a big deal,” Dr. Brull says. “If you can speak a full sentence without taking a breath, you might want to go to urgent care. But if it turns into gasping for breath every few words, then you need the emergency department.”
5. What does my gut tell me?
Don’t ignore the little voice inside you that says something serious is going on. If you can take a few minutes to call your physician’s office, do so. But also keep this in mind: Gut feeling may be another way to know you need the emergency room. “Nobody should ever delay emergency care if they believe their life, limbs, or organs are at risk,” says Dr. Brull.
6. Am I prepared?
Be sure to plan as much as possible. This is true for both the ER and urgent care. Bring your insurance card. And bring a list of your medications and allergies.
“We’ve been seeing a lot of platforms that help track your health history,” Dr. Brull says. Your health plan comes with Wellframe, a digital health management mobile app that helps you store and share your medical history. When you’re not feeling well, these apps can help make sure you have all the important information, Dr. Brull adds.
There are other ways to be prepared too. If you’re having a medical emergency, be sure whoever drives you to the ER or urgent care can stay with you. They should also help share your health information, if needed. If you’re not in an emergency, bring a snack. You can also bring something to read while you wait.
Sources
"EMTALA and Prudent Layperson Standard FAQ.” American College of Emergency Physicians. May 2024. https://www.acep.org/administration/reimbursement/reimbursement-faqs/emtala-and-prudent-layperson-standard-faq/#question0
“If You or Someone You Know Is in Crisis and Needs Immediate Help.” National Institute of Mental Health. https://www.nimh.nih.gov/site-info/if-you-or-someone-you-know-is-in-crisis-and-needs-immediate-help
