Running a Fever? Need Stitches? Here's When to Go to Urgent Care vs. the ER
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Running a Fever? Need Stitches? Here's When to Go to Urgent Care vs. the ER

Fast, professional and affordable, urgent care can handle a range of illnesses and injuries.

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By Kristen Sturt

During life-threatening medical situations, you need immediate treatment, and that's when an emergency room (ER) is critical. But what about those other times—like an ankle sprain or a suspicious rash—when your ailment or injury isn't dire, but still requires prompt attention? That's where urgent care comes in.

"Urgent care's scope of service is for minor, moderate illnesses—injuries that are not life-threatening," says Michael Kaplan, MD, a family doctor at CareNow in Montgomery, Texas. "The value we bring to the healthcare industry is fast, efficient, professional clinical care."

Many patients visit one of the nation's 7,500-plus urgent care facilities when they don't have access to their general practitioner, when they're visiting from out of town or simply, when it's more convenient. You don't usually need an appointment, and compared to hitting the ER, urgent care can be significantly cheaper. Facilities provide simple lab tests and can refer patients to emergency care or another provider if more extensive testing is necessary.

What types of injuries are treated at urgent care? From burns to broken bones, here's what you should know. 

Cuts

2 / 8 Cuts

Need more than a bandage and some antibiotic ointment? Whether you've slashed your thumb sawing through a bagel or sliced your foot on broken glass, urgent care can treat most wounds requiring suturing. "The majority of folks that walk into our clinic that need stitches—we're going to repair them," says Kaplan.

Wide cuts, wounds with jagged edges or cuts that rip through the skin entirely are good candidates for urgent care. Lacerations that are red, swollen and painful to the touch—indicating an infection—can also be examined there.

More severe wounds, including cuts that bleed heavily, very deep gashes—like those where you can see muscle, fat or bone—and lacerations on sensitive anatomical areas (face, neck, genitalia, etc.) will likely need emergency care. Surgical repair requiring sedation is also beyond what an urgent care typically covers, as well, Kaplan adds.

Fever

3 / 8 Fever

First thing's first: if your baby is 3 months old or younger and running a rectal temperature of at least 100.4°F, phone your pediatrician or hightail it to the ER. Newborn fevers can indicate serious health issues and should be treated as quickly as possible.

And while there are other situations in which a high temperature may necessitate emergency treatment—if it's accompanied by a headache and stiff neck or a rash, for example—many fevers and fever-triggering illnesses can be addressed in an urgent care. That includes sinus infections, upper respiratory tract infections and of course, the flu. Urgent care health providers can administer flu shots, as well.

Certain flu symptoms, however, need emergency care. Go directly to the ER if you:

  • Have breathing problems
  • Are suddenly dizzy or confused
  • Vomit a lot, or can't stop
  • Feel pain in your abdomen or chest
  • Have flu symptoms that get better, but come back with a bad cough and high fever

In certain fever situations—perhaps someone is older or has a compromised immune system—an urgent care doctor may examine the patient and refer them to emergency care. "We base it on clinical guidelines, your experience as a physician and the presentation of the patient," says Kaplan. "Maybe they have bad pneumonia, they're 80 years old, they're dehydrated and they just look too weak to be treated at home—and those folks are transferred to emergency room."

Burns

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Burn care is based on a few key factors, including location, depth and the percentage of the body the burn covers, says Kaplan. Burns treated at urgent care tend to be mild or moderate; they're known sometimes as first- or second-degree burns, and are typically reddish, swollen and may involve blisters. "Most of the burns we see are from spilled coffee or people touching their exhaust pipe," he adds. Severe sunburns are good contenders for an urgent care visit, as well.

"The burns that we typically won't treat are when they become more complex, or involve the hands, feet, face or genitalia," he says. "Those kinds of areas require a little more management." People with deep or severe burns, or burns spanning a significant area of their body, should dial 911 or head directly to the ER.

Sprains, strains and breaks

5 / 8 Sprains, strains and breaks

Twist your ankle carrying groceries to the car? Urgent care can (usually) handle that. "Most strains or sprains could be seen and treated in an urgent care setting," says Kaplan. "Depending on the location or the extremity, and the mechanism of injury, it could involve an x-ray and will obviously involve a physical exam." After that, doctors may stabilize the injury with a splint or ace bandage, and prescribe good ol' rest, ice, compression, elevation—and ibuprofen.

Urgent care can take care of many bone breaks, as well, including "wrist fractures, ankle fractures, fingers, toes—fractures that aren't complex in the sense that there are multiple fragments or parts extruding through the skin." After it's splinted, you would typically be referred to an orthopedic specialist for follow-up care.

It's the more serious fractures that need ER treatment; these include breaks where:

  • Pain is triggered by even very little movement or light pressure
  • The bone is broken in multiple pieces
  • Bone pierces your skin
  • Your joint (knee, elbow, etc.) or limb (arm, leg, etc.) seems deformed or oddly angled
  • At the end of a broken arm or leg, a finger or toe is numb, or seems blue at the very tip

Hip fractures and other leg breaks also need emergency room care. "Femur fractures typically require higher level of care because there can be a lot of bleeding," says Kaplan. 

Vomiting and diarrhea

6 / 8 Vomiting and diarrhea

Often, loose stools or 24-hour stomach bugs go away on their own. But if you're becoming best friends with your bathroom, you might consider a trip to urgent care. "Most of the cases we treat for vomiting or diarrhea are acute viral illnesses related to rotavirus or other types of viral illnesses," says Kaplan. Doctors can examine you, provide any necessary medications and then send you home to rest up and hydrate.

If your exam reveals signs of a more serious illness like appendicitis or diverticulitis, "those types of patients are sent to the ER for an additional evaluation." Blood in your vomit or in the toilet is another red flag that something more is wrong, and urgent care doctors can help evaluate that, as well.

If you're vomiting or having loose stools continuously and it won't stop, or are passing a large amount of blood, go to the emergency department immediately.

Skin problems

7 / 8 Skin problems

Some of the most common ailments treated at urgent care are skin-related—especially rashes. "We see contact dermatitis, rashes from shingles, childhood rashes from different viruses and rashes from plants, chemicals and metals," says Kaplan. Summertime is peak for poison ivy and poison oak, along with a range of itchy, bumpy bug bites. In many parts of the country, urgent care doctors are experts at diagnosing Lyme disease, as well.

If rashes come with signs of severe illness, like a high fever with a headache or stiff neck, go to the emergency room. But otherwise, it's infrequent these kinds of skin problems require an ER trip, and many respond to straightforward treatment or resolve on their own, says Kaplan. Some may necessitate a visit to a dermatologist. As with any urgent care-treated illness or injury, he recommends following up with a doctor.

When to call 911

8 / 8 When to call 911

In addition to some of the emergency situations discussed, like severe burns and cuts, there are several other events and symptoms that require a trip to the ER, rather than urgent care. These include, but are not limited to:

  • Chest pain, particularly if it's accompanied by arm or jaw pain, and especially in a patient with heart disease risk factors
  • Severe abdominal pain or sudden, severe pain anywhere else on your body
  • Sudden loss of the ability to move, talk or see
  • Sudden drooping on half of your body
  • Serious allergic reactions
  • Trouble or cessation of breathing
  • Sudden confusion or loss of consciousness
  • Sudden, severe or unusual headache
  • Head injuries, especially those where you lose consciousness
  • Spine or neck injuries, especially if you lose feeling or movement
  • Seizures
  • Drug overdose
  • Poisoning or smoke inhalation

Call 911 immediately if you experience any of these red flags of a health problem.