Maggie McKay (Host): Have you ever found yourself needing medical help for your child immediately and not sure whether to visit the ER or urgent care? Which is best for your child? Let's find out with Dr. Jennifer Johnson, Director, Division of Urgent Care.

Welcome to the Parent-ish Podcast, where experts at Children's Mercy Kansas City talk about the little everyday things parents experience with their babies, teens, and in-betweens. I'm Maggie McKay. Thank you so much for being here today, Dr. Johnson.

Dr. Jennifer Johnson: Thank you for having me. I'm excited.

Host: Yeah. Well, let's dive right in. What is the difference between an urgent care and an emergency department?

Dr. Jennifer Johnson: I'd really characterize it as an urgent care is a great place for taking care of acute illness and injury that otherwise you might take to a doctor's office or a clinic location rather than say needing emergency-type care, which you might call an ambulance for or take a child very quickly to an emergency room. It's really designed for those things that would be more minor to moderate in terms of their severity.

Host: Dr. Johnson, what are some examples of when I might take my child to urgent care over their pediatrician's office?

Dr. Jennifer Johnson: A good example would be a few things that maybe your doctor's office doesn't do. For instance, maybe they don't do x-rays and you're worried your child might have broken or sprained their ankle or their arm, for instance. Or another thing is that a lot of pediatrician offices don't do stitches or glue to repair a small laceration, we do those quite frequently. And then, there are some medical things that doctors offices don't do as much like IV fluids some types of shots or some sorts of therapies for breathing difficulties. We do some of that in urgent care, not as much as an emergency department, but we do provide a level of care that many doctor's offices don't routinely do, at least in a metro area anymore.

Host: And why can't I go to one location for everything?

Dr. Jennifer Johnson: Our urgent cares are equipped with more than what you'd have in a regular doctor's office, but we certainly don't have the breadth of services that the hospital has. So, that's why we can offer some lab and x-ray, but maybe not the full gamut that the ER could.

Host: And is there a rule of thumb I should keep in mind when deciding when to go to one over the other? What can help me to remember choosing to go to the emergency department or urgent care?

Dr. Jennifer Johnson: That's going to be a tough one, and I know that's why we're having this discussion today. I would categorize it in terms of how severe something is, and I'm going to give you a couple of examples, and then hopefully you can apply them to other lines of thinking. Say you're worried that your child has broken a bone, for instance, in a fall. If the extremity is still basically the same shape as it normally is, it's not crooked, that'd be great to bring to us. If the child can still, say, hobble a little bit on a leg that's been injured, that probably you can bring to us. But if minor weight-bearing is causing immense pain or an arm or a leg is crooked, for instance, that would need to go to an ER.

In terms of cuts, the type of cut where the bleeding stops within about 5 to 10 minutes of direct pressure, we can do those cuts for the most part. However, there are certain lacerations that would always require ER care. Those would be lacerations of the ear, the eye or eyelid, or even on the lips, where it crosses, say, the pink part of the lip onto the regular facial skin, or any cuts in the genital area, those would typically need to go to an emergency department as well.

So, I think we're talking about, in terms of injuries, is it more mild or moderate versus something that is far more complex or really scary, right? If you're holding pressure, on bleeding area for longer than 10 minutes and it isn't stopping, well, that's a lot scarier, isn't it, than something that you held pressure for two to three minutes. Say, you're giving your child breathing treatments to help with their breathing and the albuterol had been working and it had been lasting three or four hours, but now it's only lasting every 15 minutes. Well, If the albuterol only helps for 15 minutes at a time, that's the type of thing that should go to an emergency department because it's getting very severe. Whereas if the albuterol is still working about every three to four hours, that's probably something that we can handle in the urgent care. Those are just examples.

Host: What are the advantages of going to one over the other? Because if you're in a big city and you go to an ER, you can wait hours to be seen.

Dr. Jennifer Johnson: Absolutely. I would say the advantages for the patients are convenience, right? Getting in, urgent care typically does have a much shorter wait time. And cost is a big factor too to consider. I think those are the great things. The other thing about urgent care is in general, we try to coordinate with pediatricians in our area, having similar approaches to care, trying to coordinate, follow up quickly with the medical home. We never want to compete with that. Now, the emergency department doesn't want to compete either. But I think the emergency department, by their very nature, doesn't have that same relationship with the pediatrician the way we do. And it's probably because we're pediatricians too.

Host: Right. Okay. When should I defer to 911 or emergency services over taking my child to an urgent care?

Dr. Jennifer Johnson: If a child isn't breathing, they're not having a pulse, they're choking, they're having severe bleeding, if you've been in a car accident or another motor vehicle type of collision, seizures that are lasting more than just a minute or two, those types of things I would always call 911 for.

Host: Well, Dr. Johnson, is there anything else in closing that you'd like to add that we didn't cover?

Dr. Jennifer Johnson: I think the only other thing would be that on our website, we do have a list of things that we think are great for the urgent care and maybe more appropriate for the emergency department. I know when people are having urgencies or emergencies, that's not the time to take a look at that. But, you know, as parents and as pediatricians, we're always thinking about what could happen to the children in our lives that we love. And part of that is preparing. And I would encourage you to take a look at our website and get a sense of what we do.

The other thing is it never hurts to call one of our locations and just ask before you drive in or before you make that save-my-spot just to find out is this appropriate for urgent care, because then you don't waste time if where you really need to go is to the emergency department. And we are happy to get those calls.

Host: That's so useful. Useful information all around. Thank you so much.

Dr. Jennifer Johnson: All right. Thanks for having me.

Host: Again, that's Dr. Jennifer Johnson. To learn more, please visit childrensmercy.org/parent-ish. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. Thanks for listening. I'm Maggie McKay. That concludes this episode of the Parent-ish podcast. Again, for more parenting tips and tricks, visit us at parentish.org where we help you celebrate the craziness and challenges of parenthood.