10 Signals When to go to the ER

ER10 Signals When to go to the ER

By guest blogger, Robert J. Lueken M.D./ FAAEM

We all know when it’s time to go to the ER, right?
The short answer is:  if you’re concerned about life, limb, eyesight or acute illness that can’t wait until the morning or when your doctor can get you in, you might need to visit an Emergency Doctor.  


There is no exhaustive list of reasons of when to go to the ER, but here’s 10 that seem like common sense:

  1.  Chest pain with or without difficulty in breathing
  2. Abdominal pain not going away
  3. Cuts and Bleeding that a Bandaid™ won’t fix
  4. Broken bones
  5. Poisoning & Bites (including snakes and such)
  6. New or severe allergic reactions
  7. Unexplained fever
  8. New or changed severe headache
  9. Sudden weakness, dizziness
  10. Sudden confusion or abnormal behavior

At Emergency Departments (big hospitals), and Emergency Rooms (small hospitals or free standing centers) there are skilled emergency nurses, expert technologists and technicians.  Emergency staff are compassionate and skilled in the art of evaluating life, limb and eyesight threatening conditions as well as those that aren’t initially apparent but may require immediate evaluation.

You can also go to your local Urgent Care Center with these same complaints and you’re likely to get very good and appropriate care by someone like me and my team.  The doctors, nurses and technicians working there all received training in recognizing true emergencies, too.

As emergency medical professionals we are experts in the evaluation and treatment of breathing problems, chest pain, abdominal pain, broken bones, lacerations and bleeding.  We identify and treat life threatening infections, poisonings, bites, stings, and severe allergic conditions. We assess and initiate the treatment for seizures, diabetes, strokes, pregnancy concerns, blood clots, post-surgical conditions and any other condition that may present a diagnostic challenge with need for immediate stabilization, subsequent definitive inpatient or outpatient specialty services.

The difference in being treated by an emergency doctor is mainly optics.  An emergency doctor tends to see patients working backward from the worst possible scenario and only when true emergencies have not been found we make recommendations for immediate, then follow up care.

I had a patient tell me, at the end of their visit, “My insurance company is going to write me a nasty letter, because this wasn’t an EMERGENCY.”  I paused, thought about that statement, and then explained to them that what didn’t turn out to be an emergency wasn’t apparent until after their evaluation.  Another patient came in with findings suggestive of Appendicitis which, as we all know, is a serious condition.  They became politely indignant at the prospect of having some tests and possibly a CT scan to evaluate that diagnosis.  They said “I thought this was an URGENT CARE.”

Healthcare in America is often criticized as being too expensive.  Emergency care, despite being less than 3% of the healthcare expenditures, is actually quite valuable and will continue to be here for us all.  There will be changes in the manner in which we deliver care in the future with Telemedicine, Concierge Family Care, Alternative or holistic medicine.  Value in care, for the patient and insurance companies is important.

So the common sense answer to the question, “Should I go to the ER or Urgent Care?” is, if you’re worried you might be having an emergency health condition, then yes, go.  We’ll be there for you 24 hours a day, 365 days a year.

Dr. Lueken is a Veteran and Emergency Medicine Specialist, a Fellow of the American Academy of Emergency Medicine, Diplomate of the American Board of Emergency Medicine which is a member of the American Board of Medical Specialties.  He is experienced in many facets of Emergency Medicine from Prehospital Care, Community and Academic Emergency Medicine.

One thought on “10 Signals When to go to the ER

  1. I had to recheck what this blog said about some differences between Urgent Care and Emergency Medicine. As it pertains to Freestanding Emergency Centers:

    For more information, visit: http://www.tafec.org

    MYTH #4: “Freestanding emergency centers price gouge consumers by intentionally misleading them into thinking they are at an urgent care facility.”

    FACT: FECs provide high quality emergency care for medical emergencies, and do not hide behind the guise of an urgent care or “doc-in-a-box” in order to price gouge patients. Furthermore, the Texas Legislature has created clear guidelines for FEC operators and comprehensive regulations to ensure FECs provide the same levels of service as hospital-based ERs. Each FEC facility has signage – both external and internal – prominently displaying the word “Emergency,” postings outlining the available levels of services, and billing disclosures that patients are required to sign acknowledging they are in an emergency room setting. It is also important to note that only licensed emergency care facilities are allowed to use the word “emergency” in their name or marketing material.

    MYTH #5: “Freestanding emergency centers increase the cost of healthcare.”

    FACT: According to a 2010 University of Michigan study, the average cost of an admitted patient is $35,000 per case. Preliminary research suggests that FECs may help to reduce inpatient admission rates. By treating patients in an FEC setting and transferring only patients in need of inpatient care, FECs can improve overall efficiency and help save on healthcare costs. FECs have no financial incentive to push patients into hospital admissions, and so can serve as unbiased gateways into the healthcare system.

    The Texas Association of Freestanding Emergency Centers (TAFEC) is the first and only statewide association in the U.S. specifically created to represent freestanding emergency centers. TAFEC members work to ensure that all Texans have timely access to high-quality emergency medical care. As licensed, regulated, fully functioning ERs equipped to handle medical emergencies 24/7, our members provide expert care at convenient community locations with minimal waiting.

    For more information, visit: http://www.tafec.org

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