Urgent Care or ER? Here's how to decide where to take your child during an after-hours emergency
Posted May 4, 2020 8:55 p.m. EDT
Editor's note: This story originally appeared on UNC Health Talk.
Your son falls off his bike right before dinner. One look at his wrist, and you know he needs medical attention, but your pediatrician’s office is already closed for the day. Should you take him to the emergency department? Not necessarily. If there is one nearby, a pediatric urgent care center is your best option.
Staffed by health care providers who specialize in treating children from newborn to age 21, pediatric urgent care centers are available to you when your pediatrician’s office is closed and your child has an illness or injury that is not life-threatening. It is urgent care performed by nurses and doctors who can meet the special needs of children from birth through adolescence.
“We understand children are not little adults and that their bodies respond differently to illness and injury. They need different-size equipment and providers who are familiar with those differences,” says Dr. Cheryl Lynn Jackson, medical director of UNC Children’s Urgent Care at Raleigh.
When the Doctor Is Out
Your child’s pediatrician is the best person to see for regular medical care.
“We want kids to see their pediatrician or family doctor whenever possible. However, when they get sick or injured after the office is closed and can’t wait for an evaluation the next day, then we are here for them,” Dr. Jackson says. “Urgent care is a bridge or interim gap for the medical home, not a substitute for it.”
That’s why most pediatric urgent care centers open later in the day, usually from 4 p.m. to midnight, for the children who cannot wait until morning to see a doctor.
“Breathing problems often occur at night, and children can get really sick quickly, so they need access to quality medical care for young people at night,” Dr. Jackson says.
The late-night availability can be especially helpful for parents who are concerned about a baby’s breathing because the child is congested or coughing. “They need someone to tell them if the baby is OK or not,” Dr. Jackson says.
In addition to specially sized equipment designed for children, pediatric urgent care centers are equipped with “distraction tools,” such as iPads and bubbles, and care teams with the skills needed to help young ones cope during uncomfortable treatments such as getting stitches or having blood drawn. Having providers experienced in working with children is important. “When children need stitches, I’m pretty comfortable sewing them up—even if they are scared and crying,” Dr. Jackson says.
Avoiding a Trip to the Emergency Department
When parents are worried about their child—whether a newborn, teenager or somewhere in between—they “just need somebody to lay eyes on them, and that’s what we’re there for,” Dr. Jackson says.
Common conditions that a pediatric urgent care center can treat include:
- Burns and cuts
- Sore throat
- Broken bones
- Moderate to severe pain
- Sports injuries
- Cold or flu
Using a pediatric urgent care center also helps keep emergency departments from being flooded with children who don’t have life-threatening conditions.
“When parents have a sick kid, they want to be seen immediately; however, since emergency departments are designed to care for the sickest patients first, children sometimes have to wait a very long time if they are competing with elderly patients with chest pain,” Dr. Jackson says.
In addition, an unnecessary trip to the emergency department exposes your child to the risk of picking up an infection from someone there. Urgent care centers for children recognize that you want to keep your child safe and minimize the risk of exposing him or her to germs.
As part of standard infection prevention protocols, they have set up policies and procedures to identify, treat and limit the spread of disease in our community. Strategies such as video visits, screening processes on arrival to separate sick and injured patients, and enhanced cleaning and sanitation of rooms and equipment to conform with guidance from local and national health agencies are in place to keep patients, families and staff safe.
When a Trip to the Emergency Department Is Warranted
Sometimes you will be faced with a true emergency and need to take your child to the emergency department. If you think your child is having a life-threatening emergency or needs to be transported by ambulance, he or she should go to the emergency department, Dr. Jackson says.
Take your child to the emergency department for:
- Asthma attack (severe)
- Breathing trouble, choking, blue lips or fingers
- Broken bone if the bone has punctured the skin
- Burns (serious, such as electrical or acid burns and burns to the eye)
- Cast-related problems (soiled, wet or too tight)
- Fever of 100.4 degrees or higher if the child is younger than 1 month old
- Head injury, especially with a loss of consciousness
- Insect bite or sting with trouble breathing
- Poisoning, but call Poison Control first at (800) 222-1222
- Suicide attempt or threat to self or others, or other urgent mental health or behavior concerns
- Swallowed object (trouble swallowing or breathing)
- Unresponsiveness or difficulty waking up
If your child has a life-threatening emergency, call 911.