Emergency Department (ER) vs. Urgent Care: What Parents Should Know
It’s late Friday afternoon, and your toddler wakes from their nap cranky with a fever and tugging on their ear. Or your 7-year-old takes a nasty fall at their Sunday soccer game, and you’re concerned that they may have injured their ankle. Your pediatrician’s office is closed for the weekend, and you start to panic: Does this mean a trip to the ER? How long will the wait be? How late will we have to be there? What if they get sick from all the germs? Is this ER trip even necessary; are we wasting our time? But on the other hand, will an urgent care center be enough? Are they capable of taking care of my child?
We’ve all been there; these questions and fears are totally normal—especially when you have a little one with a schedule and a routine. But luckily, there are some general guidelines to help make the decision of what to do and where to go just a little bit easier.
First Step: Call Your Child’s Primary Care Provider (PCP) for Advice
In the event of a true medical emergency, call 911. However, some situations may fall into a “gray zone” of uncertainty—in these instances, it is always best to call your child’s primary care provider for advice. If it is normal business hours, your child’s physician may advise you schedule a same-day appointment with them to be seen, and often times, this may be the best option. Not only does the pediatrician already know you and your child, but this visit may be much quicker than the alternatives (and less expensive than the ER). Furthermore, if it is after-hours or near-closing time, your PCP will be able to advise you on where to go—the emergency department (ED, also known as emergency room, or ER) or an urgent care center. They can even provide a list of preferred facilities, such as a nearby pediatric hospital or an urgent care center that is staffed with pediatricians.
Signs that Your Child Needs to Go to the Emergency Department
In general, go to the emergency department for serious or life-threatening illnesses or injuries. For emergencies that cannot wait or if you are unable to get to the ER, you may have to call 911.
When to Call 911:
Some examples of when to call 911 include if your child is/has:
Choking
Stopped breathing or turning blue
Head injury with loss of consciousness, repeated vomiting, or not behaving normally
Poisoning or suspected poisoning and is not responding normally or has difficulty breathing (call the Poison Control Center at 1-800-222-1222)
Injury to neck or spine
Seizure lasting 3 to 5 minutes
Bleeding that cannot be stopped
Severe burn
When to Go to the Emergency Department
Some examples of when you should head to the ER with your child include if your child is/has:
Fever of 100.4℉ (38℃) or higher in an infant younger than 2 months old
Trouble breathing, shortness of breath
Confusion or unusual sleepiness
Stiff neck and fever
Continuous fast heartbeat
Poisoning or suspected poisoning (call the Poison Control Center at 1-800-222-1222)
Suspected broken bone
Dehydration—dry lips and mouth, sunken soft spot, less wet diapers/peeing less than usual, no tears when crying
For life-threatening emergencies, you should go to the closest emergency room available. If the hospital is unable to treat your child’s specific condition, they will arrange for your child to be transferred to a facility that can. For less urgent issues, however, it is best to look for a nearby children’s hospital. Children are not mini adults: What may be considered a minor illness in an adult could be dangerous in a small child. Pediatric emergency rooms are staffed with pediatricians, pediatric nurses, and others that are skilled in the assessment and treatment of children and, therefore, are preferred when possible. Enter your zip code to find pediatric emergency rooms or pediatric urgent care centers near you using the search tool on our homepage.
Some instances may not seem like a medical emergency requiring a trip to the emergency department, however, the ER may still be the right choice. For instance, a younger child with a cut on the face that may require stitches may need sedation or other behavioral support during repair—which an urgent care center is unable to provide. Furthermore, while many urgent care centers can treat minor fractures, severe fractures with bone displacement may require realignment under sedation, which urgent care centers are unable to do.
When to Go to an Urgent Care Center
An urgent care center is a good option for minor concerns that are not life-threatening that occur after-hours on nights and weekends when your child’s pediatrician may not be in the office. In general, if your child is able to walk, talk, interact, and play, an urgent care center should be considered. However, it is important to remember that not all urgent care centers have the same resources or capabilities. It is recommended to call ahead and ask if they have appropriate equipment, staff, and abilities that your child may need, such as whether they have a pediatrician on staff or if they are able to obtain x-rays (for a suspected minor fracture).
Some examples of when to consider an urgent care center include:
Common illnesses—such as the common cold, influenza (flu), ear infection, or sore throat
Minor headaches
Low-grade fevers
Limited rashes
Minor injuries—such as minor broken bones, sprains, strains, minor cuts and burns, or splinter removal
Mild allergic reactions or asthma flare-ups
Remember, just like pediatric emergency departments, a pediatric urgent care center is always preferred when possible.
What You Can Do to Prepare for an Emergency
While you hopefully may never need them, there are some specific measures you can take to help prepare for an emergency with kids. Having a first aid kit at home and a travel first aid kit in the car is always a good idea. Also, all parents and caregivers should consider completing a certified CPR and first-aid course with the American Heart Association or the American Red Cross. Furthermore, you can talk to your child’s pediatrician at their next well-visit about what local emergency rooms and urgent care centers they recommend that are properly equipped for and skilled in the assessment and treatment of the pediatric population.
Key Points to Remember
While true medical emergencies and specific conditions may require the special skills and capabilities of the emergency department, many minor illnesses and injuries can be safely and effectively cared for in an urgent care center. Urgent care centers may have shorter wait times than emergency rooms and are typically open on nights and weekends when pediatricians’ offices may be closed. It is important to always call your child’s primary care provider to help triage your child and to best advise you on where to take them for their condition—especially if you are unsure!
