Call 911 or Call Your Doctor? How to Choose When You Have a Medical Problem.
![Call 911 or Call Your Doctor? How to Choose When You Have a Medical Problem. Call 911 or Call Your Doctor? How to Choose When You Have a Medical Problem.](https://i0.wp.com/www.washingtonpost.com/wp-apps/imrs.php?src=https://arc-anglerfish-washpost-prod-washpost.s3.amazonaws.com/public/NWEN6EMQ3GOP23DQU3MZ4ONBCI.jpg&w=1440&w=1440&resize=1440,960&ssl=1)
It can be hard to know if a patient is healthy or not. “Going to the emergency room can be stressful and time-consuming,” says Kevin Biese, director of the division of geriatric emergency medicine at the University of North Carolina School of Medicine in Chapel Hill. But it’s always better to be safe than sorry, he says. The expert advice here can help guide you on what to do in some key situations.
Call 911 immediately. For some problems, it’s best to go to the emergency room as quickly as possible and by ambulance, Biese said.
“If you call an ambulance, they can start providing you with the care you need while you’re en route to the emergency room,” he explains. Additionally, the ambulance’s emergency medical technicians can communicate with the hospital, so they’ll be ready to greet you when you arrive. In some cases, paramedics can help you figure out where to take you to get the best care.
For example, if they suspect a stroke, they will take you to the nearest stroke center. In fact, according to the Centers for Disease Control and Prevention, it is important to receive clot-busting medications within one to three hours after a stroke (in some cases, it can be as late as 4 1/2 hours). Below are some examples of situations in which you should call 911 immediately.
- Chest pain.
- Shortness of breath (feeling short of breath, gasping for air, or, in severe cases, feeling of suffocation).
- The face is drooping on one side. This means that if you try to smile, your smile will be crooked, according to Biese.
- Weakness of the arm on one side. If you raise both arms, one of them drifts down.
- Difficulty speaking. You are unable to speak or your speech is slurred and unclear.
- A head injury followed by confusion, fainting, or loss of consciousness.
- Choking or respiratory arrest.
- A spinal or neck injury.
- A serious burn.
- A crisis.
- An electric shock or being struck by lightning.
Go to the emergency room. In the following cases, it’s usually best to go to the emergency room. “Have someone drive you or call 911,” says Saket Saxena, co-director of the Cleveland Clinic’s geriatric emergency department. You can also notify your doctor’s office. Take action if:
- You have respiratory symptoms (like cough, runny nose, or sore throat) and shortness of breath. This could be a sign that you’re not getting enough oxygen or developing complications like pneumonia, says Cameron Gettel, an assistant professor of emergency medicine at Yale School of Medicine in New Haven, Connecticut.
- You fall and hit your head, but you’re conscious and/or think you might have a broken bone. (If you’re taking blood thinners, consider going to the emergency room even after a minor fall.) You’ll need to be evaluated for a concussion and internal bleeding, Biese says. If X-rays reveal a broken bone, prompt care will relieve pain and can prevent complications like permanent muscle damage.
- You have a deep cut that doesn’t stop bleeding after 10 minutes. While an urgent care clinic can handle a minor cut, a deep gash that may require stitches is best taken care of in an emergency room, Gettel says.
- You experience sudden, severe vomiting that lasts more than an hour or two. You may need intravenous fluids. Additionally, such vomiting may indicate a life-threatening condition, such as a bowel obstruction.
Call your regular doctor. For most less urgent but uncomfortable situations, such as a painful muscle tear, call your doctor’s office first. Many primary care offices reserve time for people who need to be seen the same day, Saxena says.
If your regular doctor or another doctor in your office isn’t available, ask for a referral to an advanced practice health professional, such as a nurse practitioner or physician assistant, says Terry Fulmer, a registered nurse and president of the John A. Hartford Foundation in New York City, which is dedicated to improving health care for older adults. They’ll have quick access to your medical records and may already know you.
If your doctor’s office is full but affiliated with a nearby medical center, check the center’s website to see if it offers same-day appointments with other doctors in its network. Or consider searching for an opening with another local doctor on Zocdoc, Fulmer says. The online service searches for appointment slots by medical specialty, location, and insurance plan. “A lot of medical practices use it because it’s a way to fill last-minute cancellations,” she says.
On evenings and weekends, Saxena suggests calling your doctor’s office. There’s usually an on-call provider who can advise you whether you can wait to be seen when the office reopens or whether you should go to an urgent care clinic or emergency room.
Consider emergency care. For illnesses and injuries that are not potentially life-threatening, urgent care clinics, often open evenings and weekends, may be an option.
“If you tripped and think you sprained your ankle, and it’s outside of regular business hours, it’s a good idea to go to the urgent care clinic to get an X-ray to make sure and to get a bandage,” Gettel says. The clinic can also, for example, do tests for the flu and COVID-19, check your heart rate and blood pressure, listen to your lungs and, if you have pain when urinating, check your urine and prescribe antibiotics if you have a urinary tract infection.
Urgent care departments are typically staffed by physicians, nurse practitioners or physician assistants. “That’s different than an emergency room, which has board-certified emergency physicians,” Biese says. “So there may be a difference in experience and skill set.”
It’s best to go to the emergency room if your symptoms are simple. “Most urgent care centers don’t have the breadth of tests needed to try to understand a more complex situation,” Biese says. And people with serious chronic conditions, like heart failure, should probably go to the emergency room outside of their doctor’s office hours.
Another option for getting a quick opinion for simpler issues: walk-in clinics at major drugstores like CVS, Target, Walgreens and Walmart, which may be open evenings and weekends. They’re a good option for conditions like strep throat, ear infections and urinary tract infections, Fulmer says. They can also treat minor sprains, cuts that don’t require stitches and poison ivy rashes.
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