As a parent, it’s probably not news that most unexpected medical issues happen outside of your pediatrician’s regular business hours. And while your local emergency room is always open, it’s not always necessary to spend hours waiting in a busy ER. The good news is that there may be alternatives to the ER right in your own community. And what your doctor wants you to do may surprise you.
First, however, it’s important to recognize the difference between a medical emergency and a medical situation where a lower level of care may do. Emergency medical situations are:
- Life-threatening or severe situations where medical care is needed immediately.
- Those that require sophisticated tools and treatments that may be available only in an emergency department or its adjacent hospital.
- Severely affected breathing, severe burn, cuts, or lacerations requiring stitches or specialized medical care due to bleeding, fever in an infant less than two months old, head injury or alteration in consciousness, poisoning, seizure, severe stomach pain, or a swallowed object.
Situations that warrant care, although not emergent, include:
- Situations that are “minor” instead of “severe”—in other words, they are not life-threatening.
- Can be treated with basic tools or medication prescriptions.
- Examples include minor burns, coughs, earache/ear infection, pink eye, sore throat, sprain, mild stomach pain, or a potential urinary tract infection (UTI).
If your child is not experiencing a true emergency, seeking an immediate care solution may be preferred because emergency centers triage or classify patients according to needs. The neediest and most acutely ill patients will be seen first. If your child is not experiencing an emergency, he or she may have to wait significantly longer than you would at an immediate care center.
If your child is experiencing a true medical emergency, you should visit a hospital emergency room or call 911 immediately.
So where should you go if your child is ill but not in a state of emergency? First, consider calling your pediatrician even if you know the office is closed. Pediatricians are very accustomed to taking “after hours” phone calls and can sometimes deal with problems over the phone or would want to see you themselves, even if that means re-opening a closed office. In the event that they are unable to see you but believe that your child should be examined they may recommend where to go.
Walk-in doctor’s office—While your child’s pediatrician may not offer late-night or weekend hours, there is typically a physician’s office in your area that does and does not require you to be an existing patient to come in. Walk-in doctor’s offices can temporarily take the place of the doctor’s visit you would make if your child’s pediatrician’s office were open. In some towns, pediatricians rotate which office stays open late and on weekends in order to provide urgent care to their patients.
Walk-in doctor’s offices are equipped to handle similar situations as an urgent-care center. If the doctor has seen your child before, he or she may be preferred over an urgent care clinic because the doctor is more familiar with your child’s medical history.
Urgent care centers—These centers are equipped to handle moderate to minor medical concerns that may not require emergency care but deserve attention. Urgent care centers often have some blood draw capabilities as well as imaging and electrocardiogram (EKG) machines.
Go if your child has experienced a minor sports injury—such as a sprain or strain or when stitches are needed—vomiting, severe sore throat, painful urination, and fever without a rash. Look for one that specifically advertises pediatric care, as some will treat only adults. Call ahead to find out and to ask if there is a doctor experienced in pediatric care available.
Retail health clinics—These are clinics found in many pharmacies or retail superstores, such as Walmart. Medical professionals such as nurse practitioners typically staff these and can prescribe medications but often do not have on-hand imaging available, such as X-rays. It’s important to recognize that these should be a last resort and the American Academy of Pediatrics does not recommend using retail health clinics as your primary source of medical care. They often have very limited experience with children, particularly babies.
Reviewed by Dr. Sara Connolly, November 2019
- Trips to the emergency room should be limited to severe and life-threatening emergencies.
- Alternatives to going to the emergency room include urgent care clinics and walk-in doctor’s offices.
- If you child is ill or gets hurt after hours and you know it is not an emergency, call your pediatrician to see where they would prefer they be seen.