The Emergency Room: When to Go, and When Not to

By Manny Gupta, DO, MBA

Chest pressure. A mysterious rash. An unexpectedly high temperature in a child. Understandably, all these can cause anxiety, sending us in search of the fastest care available, which many believe is the emergency room. Wait times at ERs however, particularly ones at large trauma centers, can be long if someone's condition doesn't appear to be a life-threatening emergency. The good news is that less expensive, faster options are available in many communities, including the metro Charleston area.

We talked with Dr. Manny Gupta, medical director of the Emergency Department at MUSC Health Florence Medical Center for advice on when to visit your ER and when to choose an alternative that is faster, less costly, and more efficient.

Q. When should someone go to their local emergency room for treatment?

A. Someone who is showing signs and symptoms of a heart attack or stroke should get to the ER immediately. Heart attack signs include chest pain, shortness of breath, passing out, dizziness, feeling faint, sweating, and chest pressure. Signs of a stroke include difficulty talking, incoherent speech, weakness on one side, stumbling or falling, and facial drooping.

Other conditions requiring emergency treatment include sudden loss of vision, severe respiratory illness with difficulty breathing and high fever or low blood pressure, trauma, broken bones, drug reactions, acute lacerations, first-time seizures or successive seizures, and high fever and headache.

Q. What conditions are better suited for an urgent care setting or primary care physician?

A. A rash, redness or swelling can be treated by your doctor or an urgent care clinic. Cough, cold, congestion, minor fever, burning with urinating, diarrhea, constipation, migraines all can be managed safely by outpatient or urgent care.

If you have a primary care physician or a pediatrician, contacting your doctor's office and discussing the symptoms with your doctor or a nurse is the recommended first option. Physician practices sometimes have a doctor or a nurse on call 24/7 specifically for these kinds of after-hours situations.

Q. What if I don't have a primary care doctor?

A. For patients who don't have a regular doctor and require medical care immediately, MUSC Health has partnered with Doctors Care to improve access to urgent care in the Charleston area.

Q. What are the advantages of having a primary care doctor?

A. Doctors Care locations are staffed by doctors, physician assistants and nurses, and the clinics are safe, efficient, and less expensive alternatives to the ED. Clinicians treat patients 6 months and older for non-life-threatening illnesses and also have onsite lab and radiation services. They are also open evenings and weekends and cost about the same as a visit to your regular doctor.

Q. Does MUSC provide other options?

A. Yes. MUSC Health provides in-patient and online visits. MUSC Health Primary Care clinics offer same-day sick visits, Saturday walk-in clinics, online video visits, regularly scheduled appointments.

Children's After Hours Care clinics treat patients from birth to age 17. For convenience, appointments can be scheduled online.

MUSC Health Virtual Care is another easy way to talk with a healthcare provider through online video and non-video interviews that last between 5 and 15 minutes. The virtual care option is available to people of all ages and requires patients to fill out an online questionnaire. The responses are reviewed by MUSC Health providers, who typically respond to the patient in less than one hour. This virtual care option is available 24/7 and does not exceed $25.

Q. What else would you tell someone who needs emergency treatment?

A. If you think you need emergent care, don't hesitate to go to the ER. Just don't drive yourself or a family member. Instead, call an ambulance. The EMS crew can assess your situation and call ahead to alert the emergency staff, which is critical if a patient is having a heart attack or a stroke.

We take pride in what we do, and we want to make sure everyone is taken care of. And regardless of which MUSC Health facility you choose for your treatment and care, be assured that MUSC Health is committed to delivering the safest patient-centered care possible.