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When To Go To Urgent Care Vs The ER

It’s easy to determine the urgency of some medical conditions: A heart attack requires prompt care at an emergency department. Bronchitis can be diagnosed and treated at an urgent care center. But what about conditions that could be treated appropriately at either?

These choices usually depend on the intensity of the condition and/or the length of time that someone has been affected. For example, a cut that requires stitches may be treated at an urgent care center, but someone with an open gash that won’t stop bleeding should visit the emergency department. Someone with a cough, fever and no sense of smell may visit an urgent care facility to see if they have COVID-19, but someone who’s gasping for breath days after positive COVID-19 test results should go to the emergency department.

If you aren’t sure whether to go to urgent care or the emergency department, consider asking your primary care physician or calling your health insurance’s Ask a Nurse number.

“They’re not going to be able to make diagnoses by any means, but they’re going to be able to help guide you in your decision-making process,” says Maryland-based emergency medicine specialist Dr. James M. Williams, spokesperson for the American College of Emergency Physicians. “You can also call the urgent care facility or the emergency department, to at least guide you. Typically, they say, ‘Look, we can’t make diagnoses on the phone,’ but they can generally give you some information to help make these decisions.”


Sudden illness

When you fall ill suddenly, you may not need to visit the emergency department; some people can be treated at an urgent care facility. Some research has estimated that between 13 and 27 percent of visits to emergency departments could be managed at other locations, including urgent care centers, where healthcare providers treat minor acute illnesses.

“We see urinary tract infections, upper respiratory infections, bronchitis… sore throats, rashes, fever, vocal changes, cough,” says Orlando-based urgent care physician Dr. Franz Ritucci, president of the American Board of Urgent Care Medicine.

If a sudden illness is accompanied by symptoms like difficulty breathing, fainting, chest pain, confusion or vision changes, visit the emergency department. These symptoms may suggest a condition that an urgent care center may not be equipped to treat.


Cuts and burns

The location and severity of the cut or burn should help you determine where to seek medical care.

Small cuts and gashes may be handled at urgent care, unless they involve the fingers (which could involve nerve damage) or the face.

“With a dog bite to the face, as an example, that might need suturing,” Williams says. “It might need CT imaging of the face, and it may need administration of antibiotics, et cetera, which an urgent care may not be able to do.”

Burns that cover large areas should be treated at the emergency department, while small burns may be treated at urgent care. However, if you have a small burn on your hand or face, go to the emergency department.

“A hand burn, that’s worse than something on your thigh, because of functionality,” Williams says.

Burns to the head and neck may damage someone’s ability to speak or swallow, compromise the airway or lead to facial scarring. Emergency physicians have more extensive experience treating complex burns than urgent care facilities. A British study found that nurses may treat small burns at urgent care centers, rather than doctors. When your hands or face are affected, go to the emergency department.


Food poisoning

When you’re seeking medical care because of nausea, vomiting or diarrhea, an urgent care facility may be the right place to go early on in an illness.

But if you haven’t improved after a couple of days, you may need blood tests and/or rehydrating intravenous fluids, which aren’t routinely offered at urgent care centers. In that case, visit the emergency department for treatment.

“If it’s a short course, at a day, that’s fine [at urgent care]; when it prolongs over 24 hours, then you’re probably better going to an emergency department,” Ritucci says. “When the patient is having that for three, four days, now you’re talking about a different animal here, and that’s where the bloodwork comes into play.”Emergency physicians may be more accustomed to diagnosing conditions which may be life-threatening that cause vomiting, like appendicitis or meningitis. Seek care at an emergency department after several intense bouts of vomiting or diarrhea, or if you don’t begin to improve within a day.


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