When to Go to the ER vs. Urgent Care or Walk-in Clinic (video)

Scripps Health.
2019-01-02T11:31:22-08:00

Scripps doctors Shawn Evans, emergency care, and Siu Ming Geary, primary care, discuss when to go to the emergency room, urgent care and walk-in clinic.

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Learn the most common medical conditions treated

Editor's note: This video was produced prior to the COVID-19 pandemic. If you are experiencing any of the emergency warning signs of COVID-19, seek emergency medical care immediately. Call 911 or call ahead to your nearest emergency room and notify the operator that you are seeking care for someone who has or may have COVID-19. Also, don’t hesitate to seek emergency care if you are experiencing a life-threatening condition even when not related to COVID-19.

You hurt yourself in an accident, or you have a cough that won’t go away. Where do you go? The emergency room? Urgent care or a walk-in clinic? It all depends on how serious your problem is, and how you feel about wait times.

In this video, Shawn Evans, MD, an emergency room physician at Scripps Memorial Hospital La Jolla, and Siu Ming Geary, MD, an internal medicine physician and vice president of primary care at Scripps Clinic Medical Group, join San Diego Health host Susan Taylor to explain where to seek medical help for emergencies and non-emergencies.*

Knowing the difference between the places to seek care could actually save your life in a medical emergency.

Emergency care

If a situation is life or limb-threatening, always go to the emergency room. “Someone who is dizzy and has chest pain, or who has been injured and can’t get up, that’s what 911 is traditionally reserved for,” Dr. Evans says.
ER vs. urgent care, walk-in clinic

If you have a non-life or non-limb-threatening situation, you may seek same-day care at a walk-in clinic or urgent care.

Urgent care centers treat non-emergency medical conditions that are more serious than those seen at walk-in clinics. Both offer convenience. But like emergency rooms, urgent cares prioritize patients based on how sick they are, which can affect wait time.

“If you’re not extremely sick, you may have to wait because other patients who come in and have more serious conditions will be seen before you,” Dr. Geary says. That’s when walk-in clinics like Scripps HealthExpress become valuable options. In addition to offering after-hours and weekend services, walk-in clinics operate on a first-come, first-served basis and treat various minor illnesses and injuries.
What Scripps offers

Scripps offers emergency services at its hospitals in La Jolla, Encinitas, San Diego and Chula Vista. Scripps urgent care centers provide services in La Jolla, Rancho Bernardo and Vista. Scripps recently opened Scripps HealthExpress walk-in clinics at multiple locations across San Diego County.
When to go to the ER

Emergency rooms prioritize patients based on their need for immediate care.

Conditions and injuries that require such attention:

Chest pain

Difficulty breathing or shortness of breath

Broken bones or dislocated joints

Deep facial cuts

Deep scrapes or severe cuts requiring stitches

Vaginal bleeding with pregnancy

Fevers with a rash

Head injury or eye injury

Severe flu and cold symptoms

Sudden change in mental state
When to call 911

People should not hesitate to call 911 if they believe they are experiencing a medical emergency.

“It can be very hard to acknowledge that you need help,” Dr. Evans says. “Nobody wants lights, and sirens, and firemen, and folks in big, heavy yellow gear walking up to the house and knocking on their door. But calling 911 is important when you have an emergency.&quot;

“If you feel you’re going lose consciousness, can’t move and don’t have access to transportation, you need to get to the emergency department,” he says.

“In emergency cases, time is critical,” Dr. Geary adds. “If you call 911, the ambulance can take you to the emergency room that much more quickly. You don’t have to deal with traffic.”

Whether it’s an emergency or a non-emergency, it’s important to provide as much information as possible about your medical history in order to receive the most appropriate and effective care.

“Doctors and nurses need to know if you have any allergies, what medications you’re taking, including supplements, what medical problems you've had and any prior surgeries,” Dr. Evans says.
What is urgent care?

Urgent care is an option for people who have a medical problem that should be seen by a doctor within 24 hours, but is not limb or life-threatening.

If you’re planning to go to an urgent care, check whether it is equipped to properly evaluate your medical problem, especially if it involves a head injury, Dr. Evans says. “Can they do CAT scans?”

A CAT scan is an imaging test that is used to look at the brain and determine whether there is swelling or bleeding after an injury.

All Scripps urgent care facilities are equipped to provide X-rays and other imaging, IV hydration and IV treatments, including antibiotics, blood tests and basic labs.

Common non-emergency problems treated at urgent care include:

Abdominal pain

Dehydration

Fever without rash

Persistent diarrhea

Severe sore throat

Sprains and strains

Vomiting
What are walk-in clinics?

Walk-in clinics, also known as retail clinics, are staffed by nurse practitioners and physician assistants and provide same-day medical care for minor illnesses and injuries.

“These are things that you want to be seen the same day for,” Dr. Geary says. “They are not serious enough to warrant a trip to the urgent care or the emergency room, but your doctor’s office may not be open and you want to be seen the same day.”

Walk-in clinics are found in retail stores and other locations. At Scripps, HealthExpress clinics are based at Scripps Clinic and Scripps Coastal Medical Center sites.

Scripps HealthExpress clinics are open seven days a week. For those 5 and older, they are open Monday through Friday, 7 am to 9 pm, and weekends and holidays, 8 am to 5 pm.

Scripps HealthExpress treats:

Urinary tract/bladder infection

Upper respiratory infection

Ear infection

Sore/strep throat

Asthma

Allergies

Nausea

Flu-like symptoms

Cough/bronchitis

Skin conditions (including rash and hives)

Sinus infection/congestion

Mouth/oral conditions

Minor injuries

No appointment is necessary. You can walk in or call ahead to speak to a triage nurse at 858-554-7439. You can also reserve your spot online. Scripps accepts most health insurance plans and your visit is billed as a primary care visit.
Do walk-in clinics replace your primary care physician?

“No,” says Dr. Geary. “We always recommend that you see your primary care doctor for your health physicals, for chronic disease, preventive care, for anything that requires more than one visit.”

Your primary care physician acts as your personal physician and the relationship you can develop is an important one that can span decades. As your quarterback for your health care, your primary care physician helps you get and stay healthy, and will coordinate any specialty care you might need.

If you’re not sure where to go, you can call Scripps HealthExpress at 858-554-7439 for help. “Our nurse will ask you questions, and based on your symptoms and your medical history, give you advice on where to go,” Dr. Geary says.

“If you’re not sure, and it’s something you think is serious, I recommend you call 911. It’s better to be safe than sorry.”

*Content originally posted on January 15, 2019.
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