Deciding Between a Doctor Visit, Urgent Care or Emergency Care
Your child is sick or injured. Do you go to the emergency room, an urgent care center, or the pediatrician's office? Lauren Strelitz, MD, of Stanford Medicine Children's Health sheds some light on the differences between the three to help you make the best decision for your child's health.
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Learn more about Lauren Strelitz, MD
Lauren Strelitz, MD
Lauren Strelitz, MD, received her bachelor of arts in psychology from the University of California, San Diego, a post baccalaureate at Columbia University, and she received a master’s degree in law studies from UC Hastings Law in San Francisco. She attended medical school at the UCSF School of Medicine, completed her pediatric residency at UCSF Benioff Children’s Hospital Oakland, and finished an additional year of fellowship in adolescent medicine at UCSF Benioff Children’s Hospital San Francisco. She joined Bayside Medical Group in 2018. Her education and training enable her to provide a wide range of reproductive health care, including the placement of long-acting, reversible contraceptives. Dr. Strelitz enjoys spending time with friends and family, advocacy, traveling, writing and knitting.Learn more about Lauren Strelitz, MD
Transcription:
Deciding Between a Doctor Visit, Urgent Care or Emergency Care
Scott Webb: As parents, it can be difficult to know which injuries or illnesses in our kids require immediate attention, and which ones can wait until we can get in to see our pediatrician and here to help us today as Dr. Lauren Strelitz, and in addition to helping us to do a bit of triage at home and know what that means exactly. So you're gonna explain the differences between urgent care and the emergency department. This is Health Talks from Stanford Medicine Children's Health. I'm Scott Webb, Dr. Thanks so much for your time today. Thanks for joining.
Dr. Lauren Strelitz: Oh, thanks for having me.
Scott Webb: Yeah, it's my pleasure. And those of us parents in the audience, right? We've had kids and maybe they've had booboos or worse like real injuries. And there's always that debate and sometimes it's when it happens, the time of day, that kind of thing. But in general, should we go to the pediatrician's office? Should we make an appointment? Should we go to the emergency department or urgent care? So it's great to have you on to talk through some of this stuff and maybe just to define things for folks, what is the difference between the ED and urgent care?
Dr. Lauren Strelitz: ED is a place to go for medical emergencies. But also they have a greater capacity to do things that kids might need a cut or what we call a laceration on the face or in a younger child on the arm or leg. While most urgent cares can do suturing or stitches. They may not be able to do sedation. So if you have a young child who might need to be sedated in order to close the wound, that would be something that the emergency room could do that an urgent care can't do. Emergency departments tend to have pretty standardized. equipment and abilities.
Whereas an urgent care could vary tremendously. I mean, some may have an ability to do an x-ray or place a splint for you an injury in an armor leg and some may not. Some may be fully staffed by pediatric trained physicians. And some might be like family medicine or internal medicine or non-physician providers. And urgent cares, it just varies a lot in terms of what resources they have and what they're able to do. While emergency rooms tend to have more like standardized equipment and ability to perform like blood tests and imaging and things like that, urgent cares are typically designed to treat non-life threatening illnesses and.
Whereas emergency departments are equipped to handle like serious life threatening conditions, if a family's considering taking their child to an urgent care, it's always good to call in advance and find out if they have physicians that are comfortable with providing care to children. So people who are familiar with pediatrics and also depending on what's going on, finding out if they have the capabilities. So if the child. Seems like they have a broken limb. Does the urgent care have a way to do x-rays?
Do they have a way to place splints if the child has a cut or laceration? As we would say, does the urgent care have a way to do suturing stitches, not just glue? And do they have a way to, sedate the child if, which they probably don't, but those are worthwhile things to ask.
Scott Webb: So one of the things I wanted to ask you, was, are there times when we there sort of no doubters, right? When it's life threatening or something really severe, should we just stop thinking about it and go right to the emergency department or even call 911?
Dr. Lauren Strelitz: Absolutely. There are some circumstances where there should be no consideration of an urgent care or the pediatrician's office, and you should take your child directly to the emergency room. And those are gonna include, if the child is having a hard time breathing, if they're dehydrated, so they haven't like urinated at least three times in a 24 hour period. If they have what we call altered mental status, so they're acting confused or out of it, or they're difficult to wake up.
If they're having signs of a severe allergic reaction, like having a hard time breathing, having lip swelling, tongue swelling, full body rash, vomiting, diarrhea difficulty breathing in general would be a reason to go to the emergency room. Any severe head injury, if they're not able to swallow, like they're spitting out their saliva. If it's been like a trauma like being thrown off of a horse or a car accident. If they're not able to keep any fluids or fluids down. So they're vomiting everything they're taking down over the course of the day, or there's blood or dark, grassy green substance in the vomit.
If they have a trauma, like a stabbing or a gunshot wound Those would be reasons to go to an emergency department and not consider an urgent care or the pediatrician's office. Another one would be if there's like a rapidly worsening infection on the skin like streaking, redness, swelling, that, is just getting rapidly worse over the course of hours or the day.
Scott Webb: Yeah, that sounds right. It just seems, I would say common sense, but in general, if it seems life-threatening, even if you aren't sure because you're not a doctor or a nurse, probably better to err on the side of caution if there's an emergency department that's close or you can have your child taken by ambulance. So is there a difference, between a regular ED and a pediatric ED? I'm assuming because all pediatricians are amazing and super nice and friendly and wonder. That's part of the difference. But in general if a pediatric ED is an option for our child, do you recommend that?
Dr. Lauren Strelitz: Yeah, I always recommend going to a pediatric ED if that's an option. Certainly emergency medicine doctors are trained to, care for patients of all ages. But there are some nuances to taking care of younger children. Kids are not just small adults. The other reason I would say is just because the nurses are more comfortable with kids in a pediatric ED they may have more resources to help make the child more comfortable, like something called child life Services at children's hospitals help kids through procedures that may be painful or uncomfortable.
They may have like iPads and things like that to help distract the child. And so, they're just better equipped at handling emergencies in children. Of course, if it's a severe life-threatening emergency, you should go to the closest place and those emergency room doctors can transfer the child to the pediatric emergency room. But if, you do have a little bit of time, and there's one nearby, I would always recommend going someplace specific to pediatrics rather than going to a general emergency.
Scott Webb: so let's talk about then the things where it could wait, let. Something happens late in the day or in the evening, and you think, well, this is probably not life threatening. We don't need to rush out to the ED or anything like that. This can probably wait till maybe the pediatrician has like an acute hour in the morning or something. Or we can make an appointment tomorrow. So when we are trying to go through this, basically what types of things would we know are more appropriate to go to the pediatrician?
Dr. Lauren Strelitz: More mild symptoms. Cough without difficulty breathing, runny nos e, even fever. I think people do get very scared about fevers, but fever is just the body's way of fighting and. Infection, whether that's viral or bacterial. And if a child has a fever and it's like day one or day two of the fever and they're drinking, okay, and they're not having any difficulty breathing and they're lower energy, but not what I described earlier is altered mental status, confused and out of it.
If they're not having those symptoms, you certainly could wait. Any fever in a child that's been more than five days does need to be evaluated. That could be at an emergency room, urgent care, or the pediatrician's office. But generally like cold without severe symptoms could probably wait until the next day. That said, it's always good to find out if your pediatrician has an after hours advice line or if your insurance offers an after hours advice line. Because in those moments late at night, on a weekend, on a holiday. And sometimes it can be really good to talk to somebody who can help what we call triage, and they can help guide you about if you should wait, if you should do a visit right away, or if you need to go right to the emergency room.
Scott Webb: That's such a great suggestion. Are there some things that we can do to help our kids cope with an emergency? I know an emergency by definition is hard to plan for, but are there some things that we can be thinking about that we can help them get through those situations?
Dr. Lauren Strelitz: I think acknowledging their feelings is really important. I know you're not feeling well. We're gonna try to help you. I think trying to stay calm is important too, although that's much easier said than done. If you do end up needing to go to the emergency department, or even in urgent care, bringing things to entertain your child just because there is likely to be a weight that can also be helpful and reminding your child that even though they're not feeling well right now and you're gonna do everything to help them, they are gonna feel better. Like this is a temporary situation.
Scott Webb: Absolutely. Yeah, for sure. So Doctor, this has been great today, as it always is with Stanford Medicine, children's Health, pediatricians, and anybody else. I have on, I mentioned there that it's hard to prepare for an emergency of course, but we as parents, most of us like to feel like we're prepared. So is there anything that we can do if we're gonna be taking our children to the ED or urgent care, should we grab any meds they're on. Should we be keeping notes of things like from your perspective, what can we do to prepare for those emergencies?
Dr. Lauren Strelitz: So I think the first place to start preparing for emergencies. Is that your child's well check and asking their pediatrician if my child has an after hours emergency, where do you recommend I take them? Are there urgent cares that you think are more equipped to help with children, are there any emergency departments nearby that you would recommend? I think asking at the well check is really important. I think it's also really important to always know all of the medications your child is taking, any allergies they have to, any food or medications. It's good to have a first aid kit at home or in the car. It's also good to take a CPR.
Scott Webb: Yeah, absolutely. Doctor, great suggestions and tips today. I love your compassion, your energy. It's been really helpful. I hope this helps parents. I think all of us, we've been in these situations and when in doubt probably go to the emergency department just to be safe. But if it's something they can wait. Yeah, if it is something that can wait like a colder, maybe just a beginning of a rash or something an appointment with the pediatrician would be appropriate. So thanks so much. You stay well.
Dr. Lauren Strelitz: Oh, you're so welcome. You too. Thank you for having me on.
Scott Webb: And for more information, go to stanfordchildrens.org. And we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Health Talks from Stanford Medicine Children's Health. I'm Scott Webb. Stay well, and we'll talk again next time.
Deciding Between a Doctor Visit, Urgent Care or Emergency Care
Scott Webb: As parents, it can be difficult to know which injuries or illnesses in our kids require immediate attention, and which ones can wait until we can get in to see our pediatrician and here to help us today as Dr. Lauren Strelitz, and in addition to helping us to do a bit of triage at home and know what that means exactly. So you're gonna explain the differences between urgent care and the emergency department. This is Health Talks from Stanford Medicine Children's Health. I'm Scott Webb, Dr. Thanks so much for your time today. Thanks for joining.
Dr. Lauren Strelitz: Oh, thanks for having me.
Scott Webb: Yeah, it's my pleasure. And those of us parents in the audience, right? We've had kids and maybe they've had booboos or worse like real injuries. And there's always that debate and sometimes it's when it happens, the time of day, that kind of thing. But in general, should we go to the pediatrician's office? Should we make an appointment? Should we go to the emergency department or urgent care? So it's great to have you on to talk through some of this stuff and maybe just to define things for folks, what is the difference between the ED and urgent care?
Dr. Lauren Strelitz: ED is a place to go for medical emergencies. But also they have a greater capacity to do things that kids might need a cut or what we call a laceration on the face or in a younger child on the arm or leg. While most urgent cares can do suturing or stitches. They may not be able to do sedation. So if you have a young child who might need to be sedated in order to close the wound, that would be something that the emergency room could do that an urgent care can't do. Emergency departments tend to have pretty standardized. equipment and abilities.
Whereas an urgent care could vary tremendously. I mean, some may have an ability to do an x-ray or place a splint for you an injury in an armor leg and some may not. Some may be fully staffed by pediatric trained physicians. And some might be like family medicine or internal medicine or non-physician providers. And urgent cares, it just varies a lot in terms of what resources they have and what they're able to do. While emergency rooms tend to have more like standardized equipment and ability to perform like blood tests and imaging and things like that, urgent cares are typically designed to treat non-life threatening illnesses and.
Whereas emergency departments are equipped to handle like serious life threatening conditions, if a family's considering taking their child to an urgent care, it's always good to call in advance and find out if they have physicians that are comfortable with providing care to children. So people who are familiar with pediatrics and also depending on what's going on, finding out if they have the capabilities. So if the child. Seems like they have a broken limb. Does the urgent care have a way to do x-rays?
Do they have a way to place splints if the child has a cut or laceration? As we would say, does the urgent care have a way to do suturing stitches, not just glue? And do they have a way to, sedate the child if, which they probably don't, but those are worthwhile things to ask.
Scott Webb: So one of the things I wanted to ask you, was, are there times when we there sort of no doubters, right? When it's life threatening or something really severe, should we just stop thinking about it and go right to the emergency department or even call 911?
Dr. Lauren Strelitz: Absolutely. There are some circumstances where there should be no consideration of an urgent care or the pediatrician's office, and you should take your child directly to the emergency room. And those are gonna include, if the child is having a hard time breathing, if they're dehydrated, so they haven't like urinated at least three times in a 24 hour period. If they have what we call altered mental status, so they're acting confused or out of it, or they're difficult to wake up.
If they're having signs of a severe allergic reaction, like having a hard time breathing, having lip swelling, tongue swelling, full body rash, vomiting, diarrhea difficulty breathing in general would be a reason to go to the emergency room. Any severe head injury, if they're not able to swallow, like they're spitting out their saliva. If it's been like a trauma like being thrown off of a horse or a car accident. If they're not able to keep any fluids or fluids down. So they're vomiting everything they're taking down over the course of the day, or there's blood or dark, grassy green substance in the vomit.
If they have a trauma, like a stabbing or a gunshot wound Those would be reasons to go to an emergency department and not consider an urgent care or the pediatrician's office. Another one would be if there's like a rapidly worsening infection on the skin like streaking, redness, swelling, that, is just getting rapidly worse over the course of hours or the day.
Scott Webb: Yeah, that sounds right. It just seems, I would say common sense, but in general, if it seems life-threatening, even if you aren't sure because you're not a doctor or a nurse, probably better to err on the side of caution if there's an emergency department that's close or you can have your child taken by ambulance. So is there a difference, between a regular ED and a pediatric ED? I'm assuming because all pediatricians are amazing and super nice and friendly and wonder. That's part of the difference. But in general if a pediatric ED is an option for our child, do you recommend that?
Dr. Lauren Strelitz: Yeah, I always recommend going to a pediatric ED if that's an option. Certainly emergency medicine doctors are trained to, care for patients of all ages. But there are some nuances to taking care of younger children. Kids are not just small adults. The other reason I would say is just because the nurses are more comfortable with kids in a pediatric ED they may have more resources to help make the child more comfortable, like something called child life Services at children's hospitals help kids through procedures that may be painful or uncomfortable.
They may have like iPads and things like that to help distract the child. And so, they're just better equipped at handling emergencies in children. Of course, if it's a severe life-threatening emergency, you should go to the closest place and those emergency room doctors can transfer the child to the pediatric emergency room. But if, you do have a little bit of time, and there's one nearby, I would always recommend going someplace specific to pediatrics rather than going to a general emergency.
Scott Webb: so let's talk about then the things where it could wait, let. Something happens late in the day or in the evening, and you think, well, this is probably not life threatening. We don't need to rush out to the ED or anything like that. This can probably wait till maybe the pediatrician has like an acute hour in the morning or something. Or we can make an appointment tomorrow. So when we are trying to go through this, basically what types of things would we know are more appropriate to go to the pediatrician?
Dr. Lauren Strelitz: More mild symptoms. Cough without difficulty breathing, runny nos e, even fever. I think people do get very scared about fevers, but fever is just the body's way of fighting and. Infection, whether that's viral or bacterial. And if a child has a fever and it's like day one or day two of the fever and they're drinking, okay, and they're not having any difficulty breathing and they're lower energy, but not what I described earlier is altered mental status, confused and out of it.
If they're not having those symptoms, you certainly could wait. Any fever in a child that's been more than five days does need to be evaluated. That could be at an emergency room, urgent care, or the pediatrician's office. But generally like cold without severe symptoms could probably wait until the next day. That said, it's always good to find out if your pediatrician has an after hours advice line or if your insurance offers an after hours advice line. Because in those moments late at night, on a weekend, on a holiday. And sometimes it can be really good to talk to somebody who can help what we call triage, and they can help guide you about if you should wait, if you should do a visit right away, or if you need to go right to the emergency room.
Scott Webb: That's such a great suggestion. Are there some things that we can do to help our kids cope with an emergency? I know an emergency by definition is hard to plan for, but are there some things that we can be thinking about that we can help them get through those situations?
Dr. Lauren Strelitz: I think acknowledging their feelings is really important. I know you're not feeling well. We're gonna try to help you. I think trying to stay calm is important too, although that's much easier said than done. If you do end up needing to go to the emergency department, or even in urgent care, bringing things to entertain your child just because there is likely to be a weight that can also be helpful and reminding your child that even though they're not feeling well right now and you're gonna do everything to help them, they are gonna feel better. Like this is a temporary situation.
Scott Webb: Absolutely. Yeah, for sure. So Doctor, this has been great today, as it always is with Stanford Medicine, children's Health, pediatricians, and anybody else. I have on, I mentioned there that it's hard to prepare for an emergency of course, but we as parents, most of us like to feel like we're prepared. So is there anything that we can do if we're gonna be taking our children to the ED or urgent care, should we grab any meds they're on. Should we be keeping notes of things like from your perspective, what can we do to prepare for those emergencies?
Dr. Lauren Strelitz: So I think the first place to start preparing for emergencies. Is that your child's well check and asking their pediatrician if my child has an after hours emergency, where do you recommend I take them? Are there urgent cares that you think are more equipped to help with children, are there any emergency departments nearby that you would recommend? I think asking at the well check is really important. I think it's also really important to always know all of the medications your child is taking, any allergies they have to, any food or medications. It's good to have a first aid kit at home or in the car. It's also good to take a CPR.
Scott Webb: Yeah, absolutely. Doctor, great suggestions and tips today. I love your compassion, your energy. It's been really helpful. I hope this helps parents. I think all of us, we've been in these situations and when in doubt probably go to the emergency department just to be safe. But if it's something they can wait. Yeah, if it is something that can wait like a colder, maybe just a beginning of a rash or something an appointment with the pediatrician would be appropriate. So thanks so much. You stay well.
Dr. Lauren Strelitz: Oh, you're so welcome. You too. Thank you for having me on.
Scott Webb: And for more information, go to stanfordchildrens.org. And we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Health Talks from Stanford Medicine Children's Health. I'm Scott Webb. Stay well, and we'll talk again next time.