Urgent or Emergency? When Should I Go to the Emergency Room?

Nobody wants to think about a medical emergency happening to them or their loved ones, but the fact is that illnesses and accidents can happen. If they do, your health – or the health of your loved one – shouldn’t wait. Be prepared by knowing now when you should get to the emergency room, what the medical staff can do for you and when the ER may not be the best place for your symptoms.

“At the emergency room, we handle everything from poisoning and toxicology to traumatic injuries. For example, car wrecks, gunshot wounds or diving injuries,” said Daniel Lewis, MD, medical director and board-certified emergency doctor with Roper Hospital Diagnostics & ER-Northwoods, which offers a wide variety of lab and imaging procedures and a 24-hour ER for emergency care. “It’s also very common for us to see patients with abdominal pain, chest pain and all kinds of different infections.”

How do you know what’s an emergency and what’s not? Symptoms that require emergency treatment include: 

  • Irregular breathing patterns or difficulty breathing
  • Difficulty speaking
  • Fainting spells
  • Dizziness, weakness or blurred vision
  • Pain, pressure or tightness in the chest and/or abdominal area
  • Sudden change in mental status
  • Sudden and severe pain
  • Excessive bleeding that will not stop
  • Coughing or vomiting up blood

“You know your body best, and when you’ve never experienced anything like what you’re experiencing – whether it’s short of breath, having pain in your chest or stomach, or whether you fell off a ladder and think you have an ankle injury – it is time to be evaluated,” said Dr. Lewis. “One person’s definition of an emergency may be different than others.” 

Roper St. Francis Healthcare offers Express Care services that provide treatment of minor injuries and illness, such as:

  • Cold or flu symptoms
  • Sore throats
  • Sinus infections
  • Earaches
  • Upset stomachs, diarrhea or vomiting
  • Sprained ankles
  • Minor cuts or scrapes

Dr. Lewis suggests that if you have an established relationship with a doctor or express care or virtual care options available to you for a minor issue, utilize those resources first and let the medical professionals decide if you need to come to the ER.

Express Care locations are open until 8 p.m., and Roper St. Francis Virtual Care provides 24/7 on-demand access to a healthcare provider by computer, tablet or smartphone any time of day and from wherever you are. 

What can you expect once you arrive at the ER? 

“We do the initial triage and evaluation, laboratory work, urine testing, EKGs, x-rays and more advanced imaging like CAT scans, ultrasounds and MRIs,” explains Dr. Lewis. “We rely on a multidisciplinary team to assist us in getting that information, and then we make decisions about your next steps for care.” If you are showing signs of a stroke or heart attack, please go directly to the ER; Dr. Lewis reminds us that you won’t ever be turned away at an ER.

Although you might need immediate medical care, there may be some instances when you do not need to go to the ER, and a visit to one of our Express Cares could handle your minor emergency. 

Dr. Lewis recalls a patient in her mid-80s who went to urgent care complaining of shortness of breath. “She hoped that she would be diagnosed with something simple, like a cold, but as soon as she said chest pain and they looked at her medical history, they told her to go to the ER where she was diagnosed with congestive heart failure and pneumonia,” he said. 

Thanks to the current pandemic, some patients are still afraid to go to the ER. 

“Coming into the hospital can certainly be a frightening experience for folks, especially those who have quarantined and if they haven’t seen anyone outside of their household in months,” said Dr. Lewis. 

Dr. Lewis reminds patients that the emergency room doctors have had years of experience handling other infectious diseases that have come through the ER. “That includes very bad influenza seasons that we’ve had in years past such as swine flu, SARS and with Ebola a few years ago,” he said. “We also recognize that your concerns are real, and we have taken a lot of precautions. Everything is clean, sterile and safe for both the COVID-positive patients who have their own set of special needs and the non-COVID patients who we want to keep very separate from that population.” 

If you are concerned that emergency rooms are too busy for your emergency, and you are considering if you should stay at home and wait to see if you feel better, don’t. 

“Right now, emergency department volumes are down, probably somewhere around 10%, and what you’re hearing is that ERs have no capacity and are maxed out on resources. However, the vast majority of the country right now has adequate resources, and very adequate capabilities of taking care of all emergencies,” he said. 

So if you have an emergency, Dr. Lewis said it’s better to come in than wait. 

“If you have chest pain, for example, showing up a day later can cause permanent heart damage,” he said. “If you think you are having a stroke and you wait, you might not be eligible for one of our clot-busting drugs. So, the biggest message is if you have an emergency, don’t wait to be seen. It makes it a lot more challenging for your ability to get better.” 

And if you’re unable to get to the ER? 

“Call 9-1-1,” he said. 

For more information on Roper St. Francis Healthcare emergency services, visit www.rsfh.com/er