Emergency department, urgent care or virtual care? How to know where to go

It’s a Saturday afternoon and your child’s sniffles are now accompanied by a high fever. The pediatrician’s office is closed and you’re uncertain about what to do.

Do you need to go to the emergency department (ED)? What about an urgent care clinic? Is a virtual visit a possibility? Whether it’s your child, another family member or yourself who’s sick or injured, you’re not alone if you’ve ever asked yourself these questions.

Knowing where to go for care can save you time, facilitate prompt treatment and ensure emergency department resources remain available for those who need lifesaving care.

The difference and why it matters

EDs and urgent care clinics both provide medical care quickly, but one of the differences between the two is their function.

Emergency departments are designed to rule out and treat life-threatening conditions, while urgent care clinics are designed to treat illnesses or injuries that need attention but are not life-threatening — think earaches; cold and flu symptoms; bronchitis; and minor wounds, minor burns or minor fractures, for example.

Understanding this difference can help you seek the right level of care. Going to the ED for health concerns that are not life-threatening can result in long wait times and potential delays in care for yourself and others.

“A common misconception is that EDs see people on a first-come, first-served basis, but that isn’t how they operate,” says Greta Davis, DO, medical director of the emergency department at MultiCare Allenmore Hospital.

“When you walk into the ED, you’ll be assessed by a triage nurse and put in a queue based on certain medical criteria,” Dr. Davis continues. “Depending on the severity of your symptoms and situation, you could be seen later than someone who comes into the ED after you did.”

That’s one reason ED wait times can vary quite a bit, she says. Life-threatening conditions are evaluated and treated first — but the ED is sometimes a person’s only option, so if that’s the case don’t let this discourage you.

“We welcome everyone that walks through our doors no matter what their concern is,” Dr. Davis says.

During the cold and flu season, hospital emergency departments generally see high volumes of patients with respiratory illnesses, such as influenza (flu) and respiratory syncytial virus (RSV), which can contribute to long wait times.

Unless you or your loved one are dealing with a serious or life-threatening injury or illness, it’s likely best to make an appointment with your primary care provider, visit an urgent care clinic or make a virtual care appointment, if possible.

MultiCare virtual care providers can evaluate, diagnose and treat many nonemergency health problems, such as urinary tract infections, rashes, or cold and flu symptoms.

Know your options

When the unexpected happens or when you aren’t feeling well, it can be hard to evaluate your symptoms and figure out where to go. This chart shows some common health conditions and emergencies, and the ideal locations to seek treatment for each.

Note: This list does not include every symptom that may require emergency medical care. If you or a loved one may be having a medical emergency, call 911 or visit your nearest emergency department.

The gray areas

There are some situations where the level of medical care you need may not be immediately clear. For example, say you’ve broken a bone — is it minor enough that it can be treated at an urgent care clinic, or should you go to the ED?

Below, we explore some situations where you may feel uncertain about where to go and offer guidance on when you need emergency care.

Fractures

MultiCare urgent care clinics can provide X-rays and treat most minor fractures, which is when a bone breaks or cracks in a single place.

“Situations where you need to be treated in the emergency department include if you’re in severe pain, experiencing numbness or tingling, or there’s skin discoloration where the bone has been broken,” Dr. Davis says. “If a bone is protruding through the skin or the limb is misaligned or mangled, then you may need surgical care, so it’s best to visit an ED.”

Fevers

When it comes to fevers, it’s not just about how high the temperature is — it’s also important to consider a person’s mental state.

“If you have a fever and you’re confused, or very sleepy, or can’t eat or drink, then you should come to the ED immediately, no matter what your temperature is,” says Dr. Davis.

Another rule of thumb is that anyone with a temperature above 103 degrees Fahrenheit should head to the ED.

Upper respiratory symptoms

Many illnesses, from flu to RSV to the common cold, surge in our communities during respiratory season. Most people with respiratory symptoms can recover at home or under the care of their primary care provider — visiting an urgent care clinic if needed — but there are a few symptoms that warrant a visit to the ED.

“If someone is experiencing shortness of breath, has chest pain, is coughing up blood, has fainted, or their skin looks bluish or purple, then they need emergency care,” Dr. Davis says. “These are all signs that there may be serious problems with a person’s heart, lungs or blood circulation.”

Back pain

This debilitating ailment frequently leads people to seek medical help. Often, back pain can be treated by your primary care provider or in an urgent care clinic, but in some cases it’s best to go to the ED.

“When back pain has been caused by some sort of trauma, a fall or accident for example, you should come to the ED,” says Dr. Davis.

It’s also a good idea to go to the ED if your back pain is accompanied by any of these symptoms: fever; numbness, tingling or weakness; incontinence (lack of control over urination or bowel movements); or inability to urinate or difficulty urinating.

What to do if you’re uncertain — or urgent care isn’t an option

If you’re feeling hesitant or confused about what level of care to seek, always err on the side of caution and go to the emergency department.

You should call 911 for an ambulance if:

• Your condition is life-threatening
• The injured person needs to be moved by medical personnel to prevent further injury
• Distance or traffic would cause a significant delay in getting to the hospital

It’s also important to acknowledge that not everyone has a choice about where to go for care.

“Sometimes people don’t have a primary care provider, or urgent care clinic hours may not fit their schedule, or they don’t have a device they can use to access virtual care,” Dr. Davis says. “There are all kinds of reasons that people come to the ED. What we want people to know is that if you feel you need to be seen in this setting, then we are happy to see you.”