09:37 PM

ER or Urgent Care? How to Decide Where to Go When Your Child Needs Immediate Medical Attention.

When you live with a child, almost every day's unpredictable, and sometimes those adventures land your child in an Emergency Department (ED) or an Urgent Care Center (UCC).

While Cook Children's provides quality care at the Emergency Department located at the medical center and Urgent Care Centers throughout North Texas, the decision on which one to choose can be a difficult one for some parents.

"Every patient who comes into our Emergency Department is important to us. However, some patients may be able to receive the care they need from their primary care physician, a neighborhood clinic or an urgent care center," said Corwin Warmink, M.D., medical director of Cook Children's Emergency Department. "The best thing a parent can do is know what constitutes an emergency, so they know where to go when that time comes."

Choosing to go to Urgent Care or the Emergency Department can be challenging. For instance, if a child has ingested an object, where should they go?

The Urgent Care Centers at Cook Children's can take most ingested foreign bodies as long as there's no abdominal pain or vomiting. If your child is experiencing those symptoms, they should go to the ER.

A seizure can be a frightening experience for a parent, especially the first time they watch their child experience one. So, where should you go if you see a child experiencing a seizure?

"If it is a febrile seizure, or a seizure with fever, the treatment would not be a problem for our urgent care," said Kara Starnes, D.O., medical director of Urgent Care at Cook Children's. "We evaluate, educate and send those families home unless there is more than one seizure with a fever in a 24-hour period; or unless the seizure type was not the usual type that we see with a fever." Beyond that, children need to go to the ED. If your child has had a seizure that lasted more than 10 minutes, I would recommend the ED as well."

When it comes to choosing where to go, Dr. Starnes advises parents to think about the severity of the issue.

The Urgent Care Center can handle most fractures (broken bones). Fractures with severe deformities or open fractures should not come to the Urgent Care but instead should go to the Emergency Department (ED). The ED has more equipment to handle the most severe cases, and the child can be admitted quickly to the medical center for continuing care.

If your child has multiple injuries, neck injuries or head injuries with loss of consciousness and/or vomiting, they should go to the ER. These kids typically need the ER because the UCC is not as equipped in imaging and other sophisticated tests available at the medical center.

"Possible surgery, such as appendicitis, is tough for parents to determine because most of the time, abdominal pain is caused by something simple like constipation," Dr. Starnes said. "But severe abdominal pain, testicular pain or swelling, bleeding when vomiting or severe bleeding with bowel movements are reasons to go to the ER."

You should visit the ED with your child in case of a medical problem that could cause death or permanent injury if not treated right away.

Daniel Guzman, M.D., a Cook Children's Emergency Department physician, adds “when in doubt of the severity, always visit the higher level of care such as the Emergency Department” and if immediate attention is required call 911.

When to use the Cook Children's Emergency Department

  • Severe bleeding that doesn't stop after 15 minutes of direct pressure
  • Severe allergic reactions and/or breathing problems
  • Coughing up or vomiting blood
  • Sudden severe joint pain with swelling
  • Ejections from Go-Karts, ATVs, motorcycles and golf carts.
  • Motor Vehicle Crashes
  • Ocular (eye) injuries
  • Testicular pain and swelling
  • Severe allergic reactions with difficulty breathing and color change
  • Insect stings accompanied by breathing difficulties
  • Swallowing poison or choking
  • Not being able to move or speak
  • Severe or persistent vomiting or diarrhea
  • Gaping wound (edges won't come together)
  • Head injury with loss of consciousness, vomiting or causing dizziness/confusion
  • Fractures with severe deformities or open fractures
  • Fever in infants under 8 weeks old and under
  • Diabetes/blood sugar issues

If your child doesn't have life-threatening symptoms, an urgent care center can be more convenient and the right choice for your family.

Cook Children's has several urgent care clinics across North Texas. The newest clinics to open are in Prosper and the Walsh Ranch area of west Fort Worth.

When to use the Cook Children's Urgent Care

  • Ear infections/pain
  • Strep/sore throats
  • Cold symptoms
  • Flu
  • Mild dehydration
  • Breathing related illnesses, including respiratory syncytial virus (RSV), bronchitis, bronchiolitis, pneumonia and asthma without severe breathing difficulty. If a child has severe breathing difficulty and trouble catching their breath, go to the ER.
  • Sprains and possibly broken bones
  • Minor cuts
  • Vomiting
  • Diarrhea
  • Infected bug bites
  • Foreign body removal (marbles, beans and other interesting things)
  • Urinary infection symptoms
  • Pinworms, ringworm, rashes and pink eye
  • Painful muscle strains
  • Head injuries without loss of consciousness or vomiting