After-Hours Care vs. Emergency Room – What’s the Difference?

McG-Dawley_Farm-urgent-care-2012You pick up your child from daycare only to find out she is sick. Something about the way she looks makes you think she shouldn’t wait to see her regular doctor tomorrow. Where should you go—to an after-hours care location or to the emergency room?

After-Hours Care 101

First, let’s talk about after-hours care. It can also be called urgent care, acute care, ready care, quick care, and many other names. What it is: a clinic that is open past “normal” business hours. It is designed to provide medical care for acute illnesses, such as sore throats, ear infections, injuries, etc. They can diagnose and treat most illnesses, and most of those clinics have laboratory and x-ray available. You may see a physician or you may see a physician assistant (PA) or certified nurse practitioner (CNP). It is not meant to be used as a substitute for seeing your regular doctor. After-hours care does not give routine immunizations, refill medications or fill out forms for ongoing problems.

What can’t they do at after-hours care? They do not have access to more advanced radiology studies, such as CT scans or MRIs. Our after-hours care does not provide IV fluids, although some do. They also do not care for more critical problems, such as strokes, heart attacks or major trauma.

After-Hours Care vs. Emergency Room

So how do you know where to go? Think of it this way: if you or your child has a problem that you would normally go to your regular doctor or clinic for, it is something that can be seen in urgent care. If it’s a bigger problem or something you really feel shouldn’t wait AT ALL, then the ER is the place to go. Sometimes, you just aren’t sure where to go. If you go to after-hours care and they determine your problem is too severe for that setting, they will arrange for you to be seen in the ER.

What if after-hours care is closed? Then ask yourself this question: what is the worst thing that will happen if I wait until tomorrow? It is very tempting to go to the ER for a suspected ear infection in a fussy baby, but that isn’t truly an emergency (i.e. it isn’t life threatening). The pain can be managed with Tylenol and ibuprofen, and the one or two extra doses of antibiotics your baby would have received won’t make that much difference in how fast he or she gets better. However, if your child has difficulty breathing, that is absolutely a reason to go to the ER in the middle of the night. Not breathing well = not getting enough oxygen, and that can be dangerous.

24/7 Assistance

Another resource that is available to help you decide where to go is Ask-A-Nurse. Avera has nurses that will ask you questions about what is going on with you or your child and help you decide how soon a particular problem should be seen. They are available 24 hours a day, 7 days a week at 1-800-658-3535.

Hopefully you’ll never need to make the decision about whether or not to go to the emergency department, but if you do, I hope this article helps guide you in the right direction.

By Dr. Shari Eich

Pediatrician at Avera Medical Group McGreevy Clinic, Sioux Falls

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