Doctor’s Office, Urgent Care or Emergency Room: What’s the Right Choice for Your Child?

It’s 5:30 p.m. on a Friday, and suddenly your toddler’s sniffle turns into a raging fever, or maybe your 11-year-old gets hurt at soccer practice. You know they need medical care, but it can be difficult to figure out the right place to take your child. Do you go to the emergency room, an urgent care center, or the pediatrician’s office?

Pediatrician Lauren Strelitz, MD, of Stanford Medicine Children’s Health — Pediatrics in Pinole sheds some light on the differences between the three to help you make the best decision for your child’s health. Dr. Strelitz also explores this topic in a HealthTalks podcast.

In general, your child’s pediatrician should be your first stop when it comes to getting the best medical care. In addition to regular office hours, Stanford Medicine Children’s Health also offers after-hours virtual care during the week and on Saturdays, Sundays and holidays. With After-Hours Virtual Care, you can schedule same-day and weekend appointments.

“There are a lot of things that would be better served in the pediatrician’s office rather than the emergency room or urgent care,” Dr. Strelitz said. “In the pediatrician’s office, you may be able to get back to a room faster, and you can work with somebody who knows you and your family.”

Signs that your child needs to go to the ER

Unfortunately, kids have an uncanny knack for getting sick or injured outside of regular office hours. In that case, you’ll have to decide between the emergency room, which is equipped to handle serious, life-threatening conditions, and an urgent care center, which is designed to treat non-life-threatening illnesses and injuries.

According to Dr. Strelitz, if your child is showing any of the following signs, an immediate emergency room visit is warranted:

Difficulty breathing

Acting confused or out of it

Not having urinated at least three times in a day

Signs of a severe allergic reaction: difficulty breathing, lip swelling, tongue swelling, full body rash, vomiting, diarrhea

Severe head injury

Unable to swallow

Injury from a car accident

Extreme vomiting: not able to keep anything down over the course of the day, or vomiting blood or a grassy green substance

Rapidly expanding masses or infections on the skin

Stabbing or gunshot wounds

For life-threatening emergencies, you’ll need to go to the closest emergency room available. However, for less urgent issues, Dr. Strelitz recommends that families look for a pediatric emergency room, such as the Stanford Medicine Pediatric Emergency Department.

“A pediatric emergency room is always going to be best. Kids are not just little adults. There are nuances to treating kids,” she said. “The beauty of a pediatric emergency room or pediatric-specific urgent care is that they have the experience and resources to provide care specific to kids and families.”

The emergency room may be the best option even when the situation is not life-threatening because doctors in the ER, particularly a pediatric ER, will have the capabilities to handle sensitive injuries, such as wounds to the face.

“Even though a cut on the forehead or something is not life-threatening for a child, that is something that should go to an emergency room, unless you have an older teenager,” Dr. Strelitz said. “Because if they need stitches, they may need to be sedated. And even if they’re not going to be sedated, they may need to be restrained, and the pediatricians and the nurses in those settings know how to do that in a way that’s safe for the kid.”

If you do end up in the emergency room, you could be there for a long time. Waiting is hard, and that is doubly true for kids. Help them get comfortable by bringing some snacks and comfort items from home to ease the wait.

“Bring snacks, bring food, bring coloring books, bring an iPad if that’s something your family uses,” Dr. Strelitz said. “Anytime you go to the ER, be prepared for a wait. Think of it as though you were taking your child on an airplane or on a trip. What things would you use for a long, hard trip to keep them entertained? Those are the things to consider when going to the ER.”

When to go to urgent care

If your child needs medical care outside of regular business hours, an urgent care facility may be an option. Likely candidates for a trip to urgent care include colds, sprains, or other minor concerns that are not life-threatening but need medical attention.

However, not all urgent care offices have the same resources. It’s important to know before you rush over to the nearest location if they have the staff and equipment your child needs.

“Every urgent care has different capabilities. It’s always worthwhile to call and check what and who they have there,” she explained. “First of all, is there a pediatrician there? And then what equipment do they have? For example, if your child seems like they have a broken bone, does this urgent care have x-ray capabilities? If the x-ray is positive for a fracture, do they have the ability to place a splint?”

Be ready for an emergency

Although you can’t predict exactly when an emergency will take place, odds are good that if you have kids, there will be one eventually. Dr. Strelitz suggests a few steps that parents can take to be ready before an emergency strikes, such as having a first aid kit at home and/or in the car and taking a CPR course.

She also suggests that families talk about emergency care with their child’s pediatrician during a well visit to get recommendations for local facilities that can handle pediatric concerns.

“When you establish care with your pediatrician or when you have a well check, ask them what they recommend,” she said. “Your child’s pediatrician knows what the local resources are, and they may even have a list of urgent cares that they recommend that families take their children to.”

Whatever option you choose, Dr. Strelitz emphasized the importance of keeping calm so that you can help your child through the situation. “You can start by acknowledging how your kid is feeling, like, ‘I can see that you’re in pain. You’re having a hard time, and we’re going to get some help,’” she said. “I think we have to acknowledge how kids are feeling because their feelings are valid, and we want to make them feel safer. Anxiety can be contagious, so put on a calm, supporting front to help support your child.”

For more advice from Dr. Strelitz, read Teen Mental Health During Pandemic and Tips for a happy, healthy holiday season. Or, learn more about Preventing and Treating Fractures (Broken Bones).