Making sense of ‘urgent’ versus ‘emergency’ care

By Daniel Wolowiczdanielw@theacorn.com

While playing a weekend game of driveway hoops, you roll your ankle and a sharp pain rockets up your leg. In a few moments, your throbbing ankle has begun to swell and you figure it’s badly sprained, possibly broken.

Your family doctor suggests you go to an emergency room. Upon arriving, you’re told the wait may take up to five hours.

With the continual closures of emergency rooms across the United States and the increase in ER visits by people seeking regular care, waiting time in emergency rooms continues to rise.

According to a report released earlier this year by the Center for Disease Control, visits to emergency rooms increased by 26 percent between 1993 and 2003. More than 113 million people made trips to the ER in 2003.

In addition, more than 12 percent of the nation’s hospitals closed their emergency room doors during those 10 years.

Ventura County saw the closures of both Santa Paula Memorial Hospital and the Westlake Village Medical Center. Los Angeles County hospitals were hit especially hard, closing 10 of 23 emergency rooms over the past decade.

There are only seven acute care hospitals in Ventura County with emergency rooms.

Fortunately, there is an alternative. For most non-life threatening injuries, an urgent care center can offer basically the same treatment as an emergency room, generally in half the time.

“We can do 85 to 90 percent of the same things that an emergency room can do,” said Dr. Razmig Krumian, a doctor at the Westlake Village Urgent Care Center, which serves this area from its L.A. County location. “If it’s life threatening, it does not belong here; it belongs in an emergency room.”

Emergency Rooms

Call 911 if you have chest pain or difficulty breathing. The two symptoms may be signs of heart problems, a severe allergic reaction, asthma or pneumonia. Patients should also call 911 immediately if there are signs of a stroke. Symptoms may include numbness in any extremity.

It’s recommended that patients call an ambulance because immediate medical care while enroute to the hospital may be necessary. An ambulance will only take patients to an emergency room, not an urgent care center.

Serious injuries such as a bad burn, an amputation, severe head trauma, a complicated fracture or electrical shock should be treated in an emergency room.

ER attention is also required if someone shows an altered mental state, seizures or is unconscious. An ER visit is also recommended if poison is ingested.

Legally, all emergency rooms cannot deny anyone care and emergency room staff cannot ask for type of payment before medical services are performed.

Most major hospitals staff emergency rooms with doctors who are board certified in ER medicine. All emergency room doctors at Los Robles and Simi Valley hospitals are certified in ER medicine.

According the Los Robles officials, Los Robles is the only hospital in Ventura County with pediatric accreditation.

Los Robles has about 15 physicians in its emergency room rotation, while Simi Valley has seven. Both hospitals staff 35 ER nurses.

Los Robles sees about 37,000 patients in its emergency room per year, and Simi Valley reports nearly 25,000 ER visits annually.

Diane Freeman, a nurse and director of the Los Robles ER, said wait times for the hospital’s ER can be anywhere from 20 minutes to several hours, with the most critically injured patients treated first.

Emergency rooms are open 24 hours a day, seven days a week.

Urgent Care

By law, urgent care facilities must have oxygen, a defibrillator, and x-ray and laboratory capabilities.

Urgent care centers can handle a myriad of non-life threatening problems such as a cough, fever, vomiting, sore throat, diarrhea, earache, insect/snake bites and minor cuts requiring stitches.

In addition, urgent care centers treat anything from minor burns and simple fractures to removing moles and treating infected toenails.

Most urgent care centers will also provide drug screening, give travel immunizations and perform school and work physicals.

Although urgent care centers, which are typically privately owned, aren’t legally required to treat everyone, Krumian said, doctors are ethically required to provide help. Krumian said he’s never heard of anyone being turned away from his urgent care center.

Westlake Village Urgent Care Center is a privately owned facility with five physicians on staff. Krumian said the doctors are primarily general practitioners, but the center also has a hand specialist and a plastic surgeon on call.

Urgent care centers also treat patients on an as-needed basis. Wait times, however, for urgent care centers are typically shorter.

Westlake Village Urgent Care Center provides services to nearly 15,000 patients a year, clinic officials said. Their facilities are open 7 a.m. to 7 p.m. seven days a week.

Wherever you seek care, bring a list of all current medications, as well as list of any medications you’re allergic to.