Experts reveal when to go to the emergency department and when to go to urgent care
It’s the modern-day health dilemma that can cause panic in the middle of the night: your child spikes a fever, you wake up with crushing chest pain or a weekend sports injury leaves you writhing in agony.
Do you rush to the emergency department, head to a local walk-in clinic or simply wait it out? With overwhelmed hospitals and long waits, making the wrong choice can cost you precious time, money and even compromise your care.
Making the clear distinction between the ED and urgent care is critically important.
For true emergencies like strokes, heart attacks or severe trauma, every minute spent at the wrong facility delays life-saving treatment. Going directly to the ED for these conditions can mean the difference between recovery and permanent disability or death.
Meanwhile, a minor issue like a sore throat or a small cut will likely be seen, treated and discharged far faster at an urgent care than in a crowded ED where mild injuries are the lowest priority. It is also a less stressful, more appropriate environment for non-emergencies.
Dr Melissa Rudolph, an emergency medicine physician in Orange, California, affiliated with Providence St. Joseph Hospital-Orange, told the Daily Mail: ‘Urgent care is a great option for basic general medical concerns, like sprains, fractures, cold symptoms, earaches, sore throats, etc.
‘Emergency Departments are more suited to take care of serious medical conditions like abdominal pain, chest pain, neurological symptoms, breathing problems, etc.’
Below, Daily Mail outlines when you should go to an emergency department and when you should go to an urgent care.
For true emergencies, like stroke, heart attack and severe trauma every minute lost at the wrong facility delays life-saving care. Going straight to the Emergency Department can be the difference between recovery and permanent disability or death (stock image)
When to go to the emergency room
The following symptoms are clear indicators for an emergency room visit: chest pain or difficulty breathing; weakness or numbness on one side of the body; slurred speech; fainting or an altered mental state; serious burns; significant head or eye injuries; confusion from a concussion; major broken bones and dislocated joints; a fever accompanied by a rash; seizures; severe cuts, especially on the face, that may require stitches; and heavy vaginal bleeding during pregnancy.
These conditions require the immediate, advanced care that only an emergency department can provide.
When patients ask themselves whether their chest pain or other sudden health issue merits a trip to the ED, Rudolph said: ‘It truly depends on your risk factors for serious disease causing your symptoms. For young healthy patients, chest pain and shortness of breath are more likely to be due to non-emergent issues.
‘For older patients with other medical problems like diabetes, heart disease, and high blood pressure, chest pain and shortness of breath could be related to much more serious causes and should be evaluated urgently.’
Doctors in the ED typically ask their patients to rate their pain on a scale from zero to 10.
Mild pain, ranging from levels one to three, is generally nagging but manageable. At its lowest, level one, it is barely noticeable.
The map shows the percentage of US emergency departments without 24/7 attending physicians, a critical patient safety and quality-of-care issue, in 2022 due to staffing shortages
Kelsey Pabst, a registered nurse, said she sees patients in the Emergency Department for life-threatening symptoms such as chest pain with shortness of breath, stroke signs, uncontrolled bleeding, or severe abdominal pain with fever (stock image)
Moderate pain, spanning levels four to six, begins to disrupt a person’s daily routine.
Severe pain, from levels seven to ten, is debilitating. Level 10 is unbearable, often leaving a person bedridden and delirious.
People should look out for major spikes in pain levels or suddenly experiencing pain they have never felt before.
In an emergent situation, doctors typically have to perform the kinds of monitoring and testing that is far beyond the scope of an urgent care clinic, including blood tests, imaging like CT scans and/or IV medications.
With children, choosing the right medical care is especially important, such as when they have a fever and are lethargic.
Rudolph said: ‘More concerning is the way the child is acting. If a child is lethargic, meaning difficult to wake up or not responding normally, will not eat or drink, especially if their fever has resolved, they should be seen emergently in the ER.’
Urgent care is the practical choice for symptoms that have developed over days, involve mild-to-moderate (1-6/10) and tolerable pain, and show no emergency red flags like chest pain, breathing trouble or confusion (stock image)
When to go to urgent care
Urgent care is the most reasonable and efficient choice for medical concerns when symptoms have been present for days rather than erupting suddenly over minutes or hours, when pain is in the mild-to-moderate range (between one and six), is more annoying than debilitating and when there are no red-flag emergency signs like difficulty breathing, chest pain or altered mental status.
It is the appropriate setting for when you feel worried and uncomfortable, seeking answers and relief, but not when you are genuinely terrified, which is a signal that an emergency department is the necessary destination.
In general, it is advisable to go to urgent care in the event of minor burns, cuts needing stitches and minor allergic reactions without breathing difficulty.
Kelsey Pabst, a registered nurse in Missouri and a medical reviewer at Cerebral Palsy Center, told the Daily Mail: ‘Conditions such as low-grade fevers, simple fractures and mild respiratory or skin rashes without systemic symptoms can be treated with urgent care.
‘A good rule of thumb: if the difference between waiting hours could make a difference in your outcome, go to the ED.’
Doctors, nurses and nurse practitioners in urgent care also cover common illnesses such as fever, except in infants under roughly two months old, who must go to the emergency department. In addition, they treat sore throats, ear infections, diarrhea, vomiting and minor head injuries.
Urgent care can also address mild to moderate abdominal pain, minor skin conditions like rashes or infections, urinary concerns and persistent nosebleeds.
Dr George Ellis, a board-certified urologist and physician executive based in Florida, told the Daily Mail: ‘The key difference is severity: the emergency room handles critical, time-sensitive issues, while urgent care manages moderate problems quickly and affordably, bridging the gap between primary care and the ER.’
Fevers in children are not inherently dangerous and require hospitalization; they are a sign the body is fighting infection. The real concern is the child’s behavior, Dr Melissa Rudolph said (stock image)
Still, doctors caution people not to decide whether the right move is urgent care or the hospital based on the pain number. Decide based on the cause and accompanying symptoms.
When in doubt, especially with sudden, severe or alarming symptoms, the ED is the safer choice.
Ellis said: ‘If you’re unsure, err on the side of caution and go to the ER for anything that feels potentially life-threatening or could cause permanent damage if delayed.
‘In addition, a word of caution when considering severity of symptoms. There are severe medical conditions like a heart attack that may have little or no symptoms. Conversely, severe pain may not necessarily be due to a serious medical condition.’
Pabst added: ‘Pain scores help with monitoring symptoms but are not a reliable means to triage. I’ve seen heart attacks scored two out of 10 and kidney stones a perfect 10 with stable vital signs. And new or unexplained pain, or a single spot of worsening pain; also any new-onset nausea and sweating, or shortness of breath.
‘Context matters more than the number.’
