Sooner or later, all parents face an unexpected medical meltdown: The baby spikes a scorching fever in the wee hours. The preschooler swallows something suspicious. The middle-schooler wrenches an ankle at basketball practice. When faced with a medical emergency—or a situation that could become one—what’s a parent to do? Head straight for the chaotic, costly hospital emergency room? Or a local urgent care center?
Don’t load your sick kiddo into the car just yet. The best first move is to contact your child’s pediatrician, says Ernest Leva, M.D., director of the Pediatric Emergency Department at The Bristol Myers Squibb Children’s Hospital in New Brunswick, New Jersey. With knowledge of your child’s medical history and any existing conditions, your child’s pediatrician is best equipped to steer you toward the appropriate critical-care option, says Leva. And whatever treatment course you take, notifying your pediatrician allows the doctor to update your child’s medical chart and follow up as needed.
When it comes to choosing a site for quick emergency care, Leva prefers pediatric emergency departments over urgent care centers. While urgent care centers can provide fast care for minor injuries, Leva says that choosing an urgent care center first can slow down access to critical treatments. “Often, patients end up being transferred to an emergency department anyway,” he notes.
If a child needs a CAT scan, IV hydration, care for a broken bone, or surgery of any kind (for example, when a child aspirates or ingests a foreign body that must be removed surgically), the child is much better off in a hospital setting, where the required procedure can be performed quickly, says Leslie Mihalov, M.D., chief of Emergency Medicine at Nationwide Children’s Hospital. The Centers for Disease Control report that over 98 percent of emergency department patients can be treated on-site without being transferred to another facility. (And concerns over long wait times are often unfounded: over 20 percent of ER patients are seen within 15 minutes.)
When might parents want to consider an urgent care center instead of an emergency room? Urgent care centers can be a quick alternative to a regular doctor’s office visit, where patients can be treated for minor cuts, obtain prescriptions, and get basic labwork and X-rays. Another factor is cost: according to insurance provider Blue Cross Blue Shield, the average emergency room visit has a pre-insurance price tag of $1,045, while urgent care treatment comes in at just $130.
But before you write off the ER as too spendy, consider this: if your child needs to be transferred to an ER after visiting urgent care, as many do, you’ll end up footing the bill for both. Most insurance plans cover emergency room care, and federal law requires that emergency rooms treat all patients, regardless of insurance status or ability to pay.
The bottom line: “Any time a parent perceives a life-threatening condition, they should call 911 and take the patient to the emergency room,” says Leva. Conditions requiring a swift ER visit include significant injuries or deformities to limbs; difficulty breathing; ingestion of a foreign body; head injury or concussion; significant trauma or bleeding; sudden severe pain; severe allergic reactions; and dizziness, disorientation, or sudden changes in mental functioning.
Questions about fevers, vomiting, diarrhea, and flu-like symptoms should be fielded by a child’s pediatrician, says Leva, while concerns about possible poisoning warrant a call to the local Poison Control Center. Those experts will advise you on whether your child needs to head straight to the ER or not. And you can breathe a bit easier, knowing you’ve done the right thing.
Malia Jacobson is a nationally published health journalist and mom. She blogs about sleep and family health at www.thewellrestedfamily.com.
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