When to Go to the Emergency Department and When to Stay Home


There is no getting around it: healthcare is expensive. Even with insurance, it can be tough to cover the co-pays, and following the rules of which healthcare practitioners you can see (and then the waiting period) can be really confusing. But two things that most people don’t realize are that the co-pay for emergency care can be quite expensive, up to $175 per visit for some insurance companies, and, depending on the city and time of day, Emergency Department (ED) waiting times can be up to 20 hours, so it really is important if you are debating going to the emergency room, to know if you need to be there, or not.

Why can waiting times be so long?

When people arrive to an emergency room, they are triaged, which basically means that your emergency is scaled alongside everyone else’s and the sickest people are seen first, to add to that, anyone being brought in by an ambulance is ranked higher on the sliding scale of emergency issues, than those who came in themselves. For example, if someone was brought in to the ED by an ambulance after being in a car accident with a few scrapes and bruises, most often they will be seen faster than the same patient who was brought in by a friend/family. There has to be a way of scaling illness, which includes your presentation and complaint, and vital signs (blood pressure, pulse, temperature, pain) when you arrive, and when Emergency Medical Services (EMS) bring you in, it adds some acuity to the illness. That being said, EMS should only be used when necessary, not just to help you get seen faster in the ED.

Why are costs so high?

People come to EDs to be seen quickly, diagnosed with an illness, treated, and sent home, which means that every test (blood sampling, radiologic, etc.) are not only performed quickly but also read by a specialist quickly, so that you can get your results as fast as possible. In hospitals that are filled with other patients that have blood samples and tests, with limited staff and machines in the lab, so having tests in the ED run quicker comes at a premium. Most often, if you have insurance, and you are covered for your visits, your co-pay will not be charged to you if you are admitted to the hospital, as it will be buried in the rest of the costs, but it is one deterrent that insurance companies use to encourage people to go see their primary healthcare practitioner instead of going to an ED, unless they are truly sick!

True emergencies:

There are some symptoms and events that require a trip to the Emergency Department without question!

Chest pain/symptoms of a heart attack:

If you have chest pain that spreads throughout your chest, into your arms, or a heaviness feeling over your chest and you find it hard to take a deep breath, you should call EMS and go immediately to the ED. Sometimes in women, the symptoms can be a little different, such as jaw pain, sweating, heart palpitations, and extreme and sudden fatigue, so if you have those symptoms, you should also seek immediate help.

Injuries after a motor vehicle accident:

You may only appear to have a few cuts and scrapes, or a bruise here and there, but there can be much more damage to your internal organs that you cannot see. Especially if the airbag in your car was deployed, you really should go in to be seen, and if you were hurt at the time of the accident, and you have head and neck pain immediately,911 should be called so that EMS can assess you and bring you to the hospital, if needed.

Head injuries/extreme headaches:

If you have any sort of head injury, and you lose consciousness or do not feel fully “awake” after the incident you should call EMS (or have someone call for you) to be brought into the hospital immediately. As well, if you have a severe headache that starts suddenly, you should get to the hospital immediately, and if you have a severe headache that is associated with neck pain, fever, confusion, weakness, or loss of vision, you need to be seen immediately. Many times people having their first migraine headaches will come to the ED seeking treatment for fear their symptoms are something more serious like an aneurysm, stroke, or meningitis, but it is better to be seen and treated early for any of these conditions, so get to the hospital immediately.

More: 7 Ways to Stay Healthy and Happy When You’re Super Busy

Major lacerations (cuts):

If your wound is uncontrollably bleeding, something needs to be removed from the injured area (debris), there are jagged edges, or the injury was caused by a human or animal bite, seek immediate emergency care. If you cut yourself, and holding pressure on the injured area for five (5) minutes does not help to stop or slow the blood flow, if you feel a pulse in the cut, the blood is pulsating out of the wound, or when you look into the wound you see yellow fatty tissue or bone, you should go to the hospital to seek treatment as you most likely will need intervention to assist with its healing, like cleaning it out thoroughly and suturing it closed, and on some occasions, especially with bites, you may need antibiotics to prevent infection. Also if you were cut by metal, and you haven’t had a tetanus shot recently, or don’t remember your last one from 10 years ago, you will need to get one!

Abdominal pains:

If you have intense abdominal pain, along with nausea and vomiting, and/or fever, you should go to the hospital because it could be appendicitis, an infection of your colon, or something more sinister. If it is something you have felt before like possible constipation, or heartburn, you can try over the counter remedies at home, but if the symptoms don’t get better within an hour or the pain is more intense, you should be seen by a HCP.

When to stay home?

If you have had a sore throat, or have been feeling cold symptoms, you might want to try to get in to see your primary care and try some home remedies like resting, drinking lost of fluids, and warm salt water gargles, and it should get better in a few days. Many times primary care HCPs will have some time for emergency visits during the day, so it is worth giving a call to see if you can get in, OR go to a “minute clinic” that are set up in many pharmacies for a quick diagnosis and treatment.

If you ever feel that something is really not right with your body, especially with difficulty breathing, a change in mental status, and something feels really wrong and you need to be seen by a HCP, then seek immediate help and go to the ED!

In Good Health!