ER or urgent care clinic? Here’s where to take an injured child


Summer is fading like so many bathing suits on a clothing line, but for kids, this time of year is when they’re at increased risk of preventable injury.

Some local pediatric emergency doctors say that half of the traumatic injuries they see each year happen between May and September. More specifically, July and August are when the number of deaths from excessive heat, drownings, motor vehicles, and unintentional shootings for those under 18 typically peak, according to the Itsaca, Ill.,-based National Safety Council, which has tracked preventable injuries and fatalities in the U.S. for 98 years.

“Summer is trauma season,” said Dr. Charles Nozicka, director of emergency medicine at Advocate Children’s Hospital in Park Ridge. During summer, he sees kids rushed in for bone-breaking falls, near-drownings and even heat exhaustion, among other seasonal injuries.

When accidents happen, knowing where to go for treatment is key, doctors agree. But where is best for treatment of injuries and illness? An urgent care clinic or an emergency room? Some insights:

WHAT TO EXPECT FROM AN URGENT CARE CENTER:

Urgent care centers, which often fill the gap between primary care doctors and emergency rooms, have convenience and cost in their corners. Not counting retail-based clinics, there are roughly 240 urgent care centers in Illinois, according to data from the Urgent Care Association, an industry group. The association estimates that illness and injury visits at urgent care centers typically cost $115-$160. Patients here can also be seen sooner; many urgent care sites operate on a first-come, first-served basis.

WHAT TO EXPECT FROM AN EMERGENCY ROOM:

Meanwhile, there are only a handful of pediatric emergency rooms in the area, which have doctors who specialize in caring for kids. Emergency rooms, though more expensive, are better able to deal with severe injuries and symptoms, like allergic reactions, difficulty breathing, or poisonings. Things like sunburn or bothersome insect bites (unless breathing is impaired) can usually be dealt with at an urgent care clinic.

OK, SO WHERE SHOULD I GO?

That considered, two common childhood injuries will likely need to be treated in an emergency room, doctors said: badly broken bones, or bones that look out of place, and long or deep wounds. (For very young kids, doctors advise parents call their pediatrician first, if possible. Even after hours, many offices do respond with guidance.)

If you bring your child to an urgent care clinic for either of these conditions, you will likely be referred to an emergency room anyway, said Dr. Elizabeth Powell, an emergency medicine physician at Lurie Children’s Hospital. “Many urgent cares can’t do suturing, so it just takes a lot of time, and parents don’t need to have waited in two places.” And, Powell adds, “if you’ve got a broken bone that needs to have the alignment fixed, that can’t be done in an urgent care,” either.

On the other hand, some urgent care centers do stitches for less serious cuts, and some also treat less severe bone breaks.

Still, if you make an emergency room your first stop, expect to wait a bit for help.

“Most ERs are staffed by general ER doctors,” said Nozicka, the local emergency care physician. “They see all comers, so they’re not very efficient. Unless you have a true life-threatening emergency, you’re not going to be seen right away.”

Emergency rooms, which, like urgent care centers, won’t have your child’s medical history, also get “one shot at you,” Nozicka said. As a result, emergency physicians tend to rule things out and often won’t make a diagnosis. In the process, he said, “They tend to use imaging more than usual, and they also tend to order a lot of labs, which makes your visit longer, and which makes your visit less pleasant, especially if you’re a child.”

Translation: higher costs.

PLAY IT SAFE, EXPERTS SAY:

The best treatment for seasonal accidents, experts say, is to prevent them in the first place. Ensuring kids wear helmets and protective gear when on bikes, skates and scooters; keeping pools fenced off when an adult isn’t present; and being sure to use the proper safety seat restraints in a vehicle were among the top recommendations. Storing the number for the Poison Control Center (1-800-222-1222) in a parent’s cellphone is also helpful.

Vigilance is key, especially when children are near water, all agreed.

“Children always need to be supervised by an attentive caregiver,” said Deborah Hersman, president and CEO of the National Safety Council. “That means not reading, not being on a cellphone and not consuming alcohol.”

It also means making that expectation clear for other caregivers, said Hersman, a self-proclaimed “Safety Mom.” When in groups, she advises caregivers declare exactly who is watching young ones, and not simply assume that someone in the group is. Drowning, for instance, can take place quickly and quietly.

“There are a lot of ways to prevent some bad things from happening that are very easy to do,” Nozicka said. “A lot of these injuries in the summertime are preventable.”



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