When to go to the emergency room vs an urgent care clinic

UChicago Medicine emergency department

It’s Saturday, and the cold your child has been nursing for the past few days seems to be getting worse. She’s already vomited once, and has a fever. Should you head to a hospital emergency room or urgent care clinic?

If you’ve ever wondered when to go to an ER or urgent care clinic, you’re not alone. Even though urgent care centers have been around since the 1970s, many people still get confused about when to use them. There were more than 145 million visits to hospital emergency rooms in 2016, and not all of those visits required the level of care offered in an ER.

University of Chicago Medicine emergency physician and ER Medical Director Thomas Spiegel, MD, says that if you’re not systemically sick – that’s when an illness affects your entire body – then you can likely be treated by an urgent care specialist, who can stitch up cuts and treat vomiting and sprains.

“If you have a cough but don’t have a fever, you may just need urgent care,” said Spiegel. “But if you’re having chest pain, shortness of breath, or if your whole body is sick with a fever, chills and sweats, then you should go to the hospital emergency room.”

You should immediately call 911 if a person has a severe injury or allergic reaction, if they pass out or experience any signs of a possible stroke (see the list below for signs of a stroke).

Many urgent care clinics have X-ray machines and are able to deal with simple bone breaks; urgent care doctors can also prescribe medications.

“Keep in mind that staff at the urgent care will get you to the right level of care if they’re concerned,” Spiegel added.

In the United States, the number of urgent care clinics has increased every year since 2013, and now stands at 8,774. Many of them are open seven days a week – and have far shorter wait times than the ER. Another reason behind their growth: urgent care is less expensive than emergency care at the hospital. One study in 2017 found that a diagnosis at hospital ERs cost on average nearly 10 times higher than the same diagnosis at urgent care centers.

“Urgent care centers are an economical way to get medical evaluations that don’t require immediate life-saving intervention,” Spiegel said. “Your insurance company will appreciate it, as will your pocketbook if you don’t have insurance.”

When to go to the emergency room vs an urgent care clinic

Head to the ER or call 911 to have the following symptoms evaluated and treated: 

  • If you’re having shortness of breath
  • Chest pain, left arm pain or left jaw pain
  • Serious burns and cuts (cuts that won’t stop bleeding; wounds that won’t close)
  • Seizures
  • Severe allergic reaction (swelling lips, difficulty swallowing or breathing)
  • Stroke symptoms, including slurred speech or sudden numbness/weakness in any area of your body, facial droop, loss of balance or vision
  • A change in mental status (such as confusion)
  • Loss of consciousness (if you pass out or ‘fall out’)
  • Multiple injuries or a possible broken bone in areas like the ribs, skull, face or pelvis
  • If you’re pregnant and have vaginal bleeding or pelvic/abdominal pain

An urgent care specialist can evaluate and treat:

  • Fevers and colds
  • Vomiting and nausea
  • Diarrhea
  • Dehydration
  • Strains or simple bone breaks (when the body part isn’t ‘pointed’ in the wrong direction or – in the case of suspected broken ankles or knees – you can still walk on the injured leg with some discomfort)
  • Minor cuts
  • Mild asthma attacks
  • Pain with urination