Emergency Room vs. Walk-In Care

By Shelley Kofler
Emergency Room vs. Walk-In Care

With the latest surge of COVID-19 infections, many hospital emergency departments are packed. Some patients seeking immediate medical attention need that higher level of care. Others don’t, and could be seen more effectively and quickly at a walk-in clinic.

Dr. Ralph Riviello is chair of emergency medicine for University Health and UT Health San Antonio. He has identified five criteria to consider when deciding where an adult should seek treatment, and he has advice on when to call 911.

Where are they experiencing pain? 

Certain conditions like chest pain, severe headache, eye complaints or severe abdominal pain can indicate more serious conditions and are better evaluated in an emergency department than urgent care.

Most other things related to follow-ups for a chronic medical problem, a simple X-ray, a throat swab or a COVID swab without any significant symptoms could be seen in any of the walk-in clinics or family doctor offices.

What is their mental state? 

Are they really confused? Are they not making sense when they speak? Do they not seem to be like themselves? That could indicate something very serious and you should take that person to an emergency room. 

Is their appearance abnormal? 

How do they look to themselves? How do they look to their family and friends? Are they really sick looking, pale or profusely sweating? Are they in a lot of distress? Those kinds of things should go to an emergency room.

How severe is the pain? 

If it’s really severe pain or something you’ve never experienced before, or if the person is crying and screaming in pain, that may indicate something very serious and should probably be evaluated in the emergency department.

Most of us have had a mild stomach ache, and we deal with it or let it pass because usually they’re not that serious. But if it’s really dramatic pain, that might be something better suited for the emergency department.

How serious is the injury? 

Most of the time when we cut ourselves, they’re pretty mild and can be sutured in any walk-in clinic that has those services. But if big pieces of muscle are sticking out, or you lacerated your hand and you can’t move your fingers because there was a tendon injury or it was very deep, those should probably go to the emergency department.

If you twist your ankle and it’s a little bit swollen and it hurts to walk, any walk-in clinic should be able to get you an X-ray and decide if your ankle is sprained or fractured. But if the bone is sticking out or your foot is pointing in the opposite direction than it normally does, or if it’s really cold and your leg is very numb, those should go to an emergency room.

When should you call 911 for an ambulance?

Calling 911 should be reserved for people who are having the most severe symptoms, like heart attack, chest pains, stroke or stroke-like symptoms. Anybody who can’t walk or get themselves to the emergency department should call 911.

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