Urgent Care vs. the Emergency Room: Where Should You Take Your Child?

Author:  Rima Rusnak, M.D.
Medical Director of the Urgent Care Centers at Cincinnati Children’s Hospital Medical Center

Imagine this: It’s a Monday evening and your daughter has not been feeling well all afternoon. You were hoping that she would be okay until tomorrow so you could get her in to see her pediatrician, but she only seems to be getting worse. Will she be okay if you wait until tomorrow to see a doctor? Should you take her to an Urgent Care, or maybe even to the Emergency Room? 

If at any time you just aren't sure where to go, often the best way to decide is to call your physician; he or she will direct you to the appropriate level of care. If you feel like you don’t have time to wait for a call-back from the physician on call, you should call 911 for help and a ride to the ER.

Here’s some information that may help you decide what to do and where to go if you find yourself in a similar situation. We will first review common emergencies and then discuss urgent (not emergent) medical concerns.

First, life-threatening emergencies should be handled in the Emergency Room (ER), and a call to 911 is the best way to get there. Please don’t try to take your critically ill child to the ER yourself. 

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Life-threatening emergencies include (but are not limited to):

• Breathing difficulties (including severe asthma attacks where the child is wheezing too much to count to ten or a baby is wheezing too much to drink or nurse)
• Severe trauma
• Seizures
• Allergic reactions with breathing problems, swelling, and/or vomiting
• Head injuries with loss of consciousness
• Neck injuries 

If your child’s injury or illness is not life-threatening, but needs emergent attention, your child should 
be seen in the ER, but does not necessarily need to go by ambulance.

Here are some emergent types of patients or situations that should be seen in the ER:

• Very young, un-immunized infants (<2 months of age) with fever or illness such as vomiting or diarrhea.  These patients should go to the ER because they will need testing that cannot be offered at an Urgent Care.
• Children with extensive chronic medical problems. 
• If your child has chronic medical problems, you should have a plan in place with his or her care providers that details exactly what you should do if you need help urgently.
• Psychiatric or social service problems. 
• Reproductive care or sexually transmitted infections.  Patients seeking this type of care should contact their physician’s office, or Planned Parenthood. If there is urgent need for this type of care, one of the ERs will be most appropriate.
• Emergency dental treatment. 
• Severe abdominal pain concerning for appendicitis. Lower right abdominal pain can be a sign of appendicitis.  

If your child does not have an emergent problem (but still needs to be seen quickly), and your pediatrician’s office is closed, Urgent Care is most likely the place to go.  It is helpful to remember that going to Urgent Care is similar to going to your physician’s office, with a few added services. 

Here are some of the most common things we examine and treat at Urgent Care:

• Simple lacerations (which may require stitches) and wounds
• Fractures and injuries to arms, legs, fingers and toes (bone not sticking out of skin)
• Ear aches
• Runny noses
• Cough 
• Fevers (fever at or above 100.4 in children under 2 months of age and very high fever in children under 6 months of age should go to the ER)
• Common pediatric illnesses such as mild asthma attacks (cough and mild wheezing), stomach flu, diarrhea, vomiting, rashes, and strep throat
• Minor burns

Pediatric urgent care/emergency physicians can often stitch up a 2 year old without sedation; pediatric facilities have the right tools and correctly trained people to keep the experience from being traumatic for kids. 

Cincinnati Children’s Hospital Medical Center has two Emergency Departments (Burnet Campus [Main] and Liberty Township) and four Urgent Care locations (Mason, Anderson and Green Township, and Burnet [Main] Campus). 

For more information on Cincinnati Children’s Emergency Departments and Urgent Cares, click here 



Rima Rusnak, MD

Debunking Myths about the Emergency Department

Debunking Common Myths about the Emergency Department

Overuse of the Emergency Department is a problem in Cincinnati and nationwide.  In North Carolina, Natania Barron of Blue Cross, Blue Shield put together a list of "myth-busters".  People who know the facts are more likely to “Make the Right Call".

Myth #1: The uninsured are to blame for unnecessary ER visits.  

Fact: Contrary to popular belief, it’s not the uninsured who make up the majority of these “ER overusers.” Increasingly, it’s people with insurance. In fact, according to CDC data, Medicare beneficiaries are the most likely to visit the ER — and those without insurance are no more likely to visit the ER compared to those with private insurance.  

Myth #2: Going to the ER is “free” if you can’t pay. 

Fact: This is a classic example of consumers being shielded from the true cost of health care. While it’s true that out-of-pocket costs can be as low as zero for the uninsured or the cost of a copayment for insured patients, we know that the average trip to the emergency room really costs an average of about $1,500. Those ER costs pile up and are part of the reason that health care costs have been rising so much faster than inflation and salaries for the past decade.

Myth #3: I can’t tell if it’s an emergency, so the ER is the best way to go. 

Fact: This is a tough one, but it comes down to education and availability. Researchers have concluded that more than half of all ER visits are not serious enough to require a visit to the ER and could be treated at a doctor’s office or urgent care center at much lower costs. That makes a big impact on the cost of health care for you and everyone around you, whether or not you’re using the ER incorrectly. Of course there are always situations that absolutely require an ER visit—but it’s important to know the difference. Not just for your health, but for your checkbook, too.

Myth #4: You’ll get help quicker in the ER. 

Fact: Nationally, the average ER patient wait time is four hours. That’s a long time, especially if you compare that to other care options like a primary care physician's office or urgent care centers where the average wait time can be much shorter.

Myth #5: Ambulance rides are free. 

Well, in some places, they used to be. But that’s no longer the case. The New York Times recently wrote a piece about the skyrocketing charges for ambulance rides, including the story of an insured woman who was charged over $1,700 for an ambulance ride to the ER. 

Click here to read the full article.  

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