Is it really an emergency?

July 8, 2014
Q. Thomas Novinger, M.D.,MBA, is Senior Medical Director for Blue Cross of Northeastern Pennsylvania. Image Provided.

Many of us have been in a situation where an accident or injury around the house - cutting a finger while preparing dinner or falling from a stepladder while cleaning or hanging decorations - leads to the question “should I go to the emergency room?”

Nationwide, hospital emergency rooms (ERs) treat nearly 130 million patients each year, mostly for serious injuries and illnesses.  But according to the Centers for Disease Control and Prevention (CDC), at least 35 percent of ER visits stem from non-life threatening conditions such as fever, headaches and coughs that could have been managed in a primary care provider’s office.

The CDC also reports that 63 percent of the nearly 130 million patients visiting an ER each year spend more than two hours total in the ER, so it’s easy to see that going to the ER for non-life threatening conditions can contribute to overcrowding and longer wait times.

How do we determine, then, when an injury or illness is severe enough to go to the ER?

Conditions that can be treated with basic first-aid techniques or over-the-counter remedies - such as a fever, cough, cuts or sprains - generally do not require a trip to an ER.  (If you’ve never taken a first-aid course, please do.  Many local organizations offer them for minimal cost, and the skills you will gain are invaluable.)

For example, a twisted ankle can usually be treated at home with an ice pack and by elevating the ankle to reduce swelling until you can see your regular health care provider.  A broken ankle, however, may require a trip to the ER to ensure that the bone is set as quickly as possible for proper healing.

During the summer months, it’s easy to get sunburned even if you are outside for just a short time.  Most cases of sunburn, unless there are blisters or welts present, can be treated with over-the-counter creams and lotions.  Blisters and welts may indicate a more severe burn, which may require a trip to the ER.  Insect stings are another frequent occurrence during the summer.  Unless the person who is stung has an allergic reaction, the sting can usually be treated topically with cool towels or ice.

If you are unsure about the seriousness of any injury or illness, go to your local emergency room immediately.  In non-emergency situations, though, it’s important to know your options for accessing appropriate care in an appropriate setting within an appropriate time.

One such option is a visit to an urgent care center.  These facilities are staffed by physicians, nurses, physician assistants and other medical professionals who provide basic treatment for non-life threatening conditions and illnesses, such as sore throats, rashes, minor bruises and muscle strains.  They typically have specific hours of operation, unlike emergency rooms that are open 24/7.

While individuals are encouraged to use the care of their own primary care physician whenever possible, urgent care centers are a convenient and cost-effective alternative for non-emergency care for patients who don’t have access to a primary care physician.

According to the Urgent Care Association of America, there are approximately 9,000 urgent care centers in the U.S., the majority of which provide primary care, occupational medicine, routine immunizations and physical exams.  About half also provide lab tests, X‐rays, fracture and laceration care, and intravenous fluids.

Because we recognize the value of patients having options for appropriate care, many insurers like Blue Cross of Northeastern Pennsylvania (BCNEPA) include an urgent care benefit with their coverage.  In fact, BCNEPA offers urgent care benefits with most coverage options, and encourages members to visit its website (bcnepa.com) to compare doctors and hospitals for cost and quality before having non-emergency procedures or treatment.

By taking some time to educate yourself on the options for non-emergency care in your area before an accident or injury happens, you may be able to avoid long wait times at the ER and still get the care you need in an appropriate setting.  In the long run, that’s what really matters.