Sledding mishap? When to go to immediate care or emergency room
By Lara Krupicka For Sun-Times Media March 4, 2013 2:16PM
One way to improve the chances of surviving a heart attack is by calling 9-1-1. Ambulance personnel are able to start treatment as soon as they pick up a patient and can drive to the hospital more quickly than a non-emergency vehicle.
Major bone break
Bleeding that will not stop
Difficulty with breathing or shortness of breath
Chest pain or other signs of heart attack
Coughing or vomiting of blood
Head or spine injury
Psychiatric issues (suicidal or murderous impulses)
Severe or persistent vomiting
Sudden dizziness, weakness or change in vision
Upper abdominal pain or pressure
Suspicion of stroke
Fainting or loss of consciousness
Sudden, severe pain of any kind
Source: the American College of Emergency Physicians and the National Institutes of Health
Symptoms of ear or sinus infection
Sprain, fracture or minor bone break
Cold, cough or sore throat
Fever or flu-like symptoms
Non life-threatening allergic reactions
Minor burns or cuts
Rashes and other skin conditions
Employer-mandated drug testing
Source: National Association for Ambulatory Care
Did you know?
“Immediate care” or “urgent care”?
In most states extended-hour walk-in medical service centers are called “urgent care centers.” However, in Illinois the terms “immediate care” and “convenient care” are more often used because of a state law prohibiting any facility other than a hospital emergency room from using the terms “urgent,” “urgi-,” “emergi-,” or “emergent” in its name.
Updated: March 12, 2013 11:55AM
Here’s a quick quiz first. What do you do if your child breaks her finger during gym class one morning: Take her to the emergency room or immediate care?
In my case, I took my daughter to Edward Hospital’s Immediate Care Center instead of the emergency room. After a short visit with a physician, a quick X-ray, and the application of a splint, the Naperville eighth-grader returned to school in time for lunch.
Scenarios like mine are commonplace with local hospitals, private companies and retail drugstores operating more one-stop medical clinics. However, knowing when to choose immediate care or the emergency room can be difficult. Thankfully, it just requires a little common sense.
“It’s a blend of considering the severity of the problem and the convenience,” says Dr. Tom Scaletta, medical director of emergency services at Edward Hospital. “And how much comfort you want to have if you make the wrong decision.”
Immediate care centers offer a range of services that make them a convenient place to visit when it’s not possible to visit a primary care doctor or when it’s obvious a patient will require basic medical services beyond a checkup.
Centers usually have X-ray equipment for diagnosing conditions such as bone fractures or pneumonia. They also provide medical testing and lab work, simple stitches, burn care, immunizations and issuing of prescriptions.
For Naperville resident Laura Nilles the decision was easy when her daughter Erika Gearhart complained of an earache one weekend. Guessing it was an ear infection that would require antibiotics, she took Erika to an immediate care center when the wait times at a nearby Walgreens clinic were too long.
“I definitely would not have gone to an ER,” Nilles says. “I’m very happy to have options when we’re sick on the weekend.”
When it comes to convenient medical care, not all centers have a “doc in a box” feel. Residents have been raving about the recently opened MedSpring Immediate Care Center in Southeast Naperville where patients are offered an array of drinks and snacks while they wait to see a doctor.
MedSpring President and CEO Heath Schiesser attests that patient reviews on the company’s website have been positive. He attributes his company’s success to an attention to quality care and efficient service.
“We use e-records. Our doctors summarize their notes and get them to the primary care physician by noon the next day,” he explains. “Visits take 45 minutes. So patients are in and out in one hour.”
Often patients will visit immediate care at night or on the weekends, when they can’t get in to see their primary care doctor. But as Nilles points out, sometimes a patient’s own schedule makes immediate care a great option.
“I work full time and can’t take a day off. Our doctor is in Berwyn,” she says.
As Scaletta says, “it’s like an unscheduled primary care visit.”
But Schiesser also notes immediate care should operate as a stopgap, rather than taking the place of a regular doctor.
“We’re not currently the place for longitudinal care,” he said. “You do need a primary care physician.”
Cost also can make a difference. Depending on the patient’s insurance plan, the basic fee for an emergency room visit (before any fees for specialists and additional treatment) may run between $100 to $200.
Co-pays for immediate care typically range between $35 to $50.
It can help to shop immediate care centers using your own insurance information to find out what a visit will cost, as rates can vary.
But in the event of a true emergency, such as a head injury, heart attack symptoms or sudden severe pain, it’s always advisable to call 9-1-1 or head directly to the emergency room.
“If you think it’s a time-sensitive emergency, then you probably do not want to be in an immediate care center,” Scaletta says.