Urgent Care or Emergency?

By Dr. Jamie Lien

It’s five o’clock on a Friday afternoon and your child has just twisted her ankle. What should you do? You want to get medical treatment for her, but you don’t want to go to the emergency room if you don’t have to, and you aren’t sure whether you can take her to an urgent care center.

Medical problems like this don’t always come up at convenient times, and it can be hard to know where to go when your doctor’s office isn’t open. Unless your child is experiencing a life-threatening emergency, your child’s primary care medical provider is still the best place to start. Call your pediatrician’s office if you are not sure what to do, and you should be able to speak with health care providers who can help you decide if your child can wait until regular business hours to be seen, or if she needs to go to an urgent care center or an emergency room. They can also provide advice for treatment at home. Some insurance plans have a nurse advice line that can help as well. If your child is having problems related to a chronic health condition which is treated by a specialist, contact your on-call specialist.

Urgent care centers have extended hours and can treat injuries or illnesses that are not life- or limb-threatening but need immediate attention. Urgent care centers can usually run diagnostic tests for urinary tract infections, strep throat, influenza and pregnancy, and can provide prescriptions if needed. Some can also perform basic radiology and laboratory testing.

Examples of medical problems that can be evaluated in an urgent care center include sprains and strains, contusions (deep bruises), minor lacerations, mild to moderate asthma attacks, ear infections, upper respiratory infections, cough and congestion, vomiting and diarrhea, sore throats, insect bites and rashes. Urgent care centers do not provide well-child care, routine childhood immunizations, emergency care or major trauma care and do not treat complex fractures.

If your child has an injury or illness that is life- or limb-threatening, or if you are not sure, go to an emergency room. Call 911 if you feel your child needs medical attention immediately. Examples of symptoms that should prompt a trip to the emergency room include difficulty breathing, uncontrolled bleeding, coughing or vomiting blood, severe or persistent vomiting or diarrhea, changes in mental status and severe musculoskeletal injuries.

Emergency rooms are open 24 hours a day, and can provide laboratory and radiology services as needed. They will always see your child, but they treat patients with the most serious conditions first, and may not be the fastest choice for your medical care needs.

For more routine medical issues, going to an emergency room might not be the most cost-effective way to get the right care for your child. The cost of an urgent care visit is usually a fraction of the cost of an emergency room visit, whether you are paying a co-pay or out-of-pocket. Some insurance plans will not cover the cost of an emergency room visit for what they consider non-emergency care.

Ask your primary care physician which urgent care center or emergency room she recommends. You can also check with your health insurance company to see which facilities belong to your insurer’s network.

The Emergency Care Center at Rady Children’s Hospital-San Diego is the only emergency room in the region dedicated to caring for kids, and is the only Level 1 pediatric trauma center in San Diego County. Rady Children’s also operates four urgent care centers that are open daily in La Mesa, Escondido, Mid-City (San Diego) and Oceanside.

Dr. Jamie Lien is a pediatrician in the emergency department at Rady Children’s Hospital-San Diego, and an assistant clinical professor of pediatrics at UC San Diego. She can be reached at jlien@rchsd.org.