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10 | Health Matters: Providence Saint John's Health Center Do I Need Emergency or Urgent Care? When an unexpected health issue arises, it helps to know the differences between the ER and urgent care. I nstinct tends to take over when one is faced with the question "Do I need to go to the ER or to urgent care?" The simple answer depends on whether an injury or illness is life-threatening. Providence Saint John's Health Center 's state-of-the-art emergency department is well equipped to treat all emergent and urgent health needs, but is it the best option? Situations that call for a visit to the emergency department—or even a call to 911—are health events that are "life-threatening," "acute" (occurring suddenly) or "systemic" (affecting the whole body). These circumstances all require immediate medical attention in an emergency department. Examples include sudden-onset chest pain (a classic sign of heart attack), sudden-onset or rapidly progressing shortness of breath, sudden arm or leg weakness or difficulty with speech that could point to a stroke, uncontrollable bleeding or a sudden, severe headache. Likewise, severe burns over 30% or more of your body, sudden, severe abdominal pain, irregular or rapid heartbeat, loss of consciousness or psychiatric crises such as suicidal thoughts are best dealt with in an emergency department, where there is access to diagnostic tools and other resources to provide timely care and treatment. However, when the health concern doesn't rise to the level of an emergency, a trip to an urgent care center may be a more convenient option. Conditions best treated here include an itchy rash, an injury that might need stitches, a sore throat, a sprain, a broken finger, persistent diarrhea or an anxiety attack. HOW TO DECIDE BETWEEN THE ER AND URGENT CARE Typically, ERs are associated with longer wait times and higher costs, while urgent care centers are more like a same-day visit to the doctor, although many are equipped with extra resources to care for urgent conditions. Patients in the ER are prioritized by severity of illness, with the sickest patients treated first, whereas in an urgent care clinic, patients are seen in order of arrival and sometimes even by appointment. Costs are higher in the ER because the department is fully staffed 24/7/365, with access to the hospital's lab, imaging and on-call surgeons and specialists. Urgent care centers have some, but not all, of these resources and therefore cannot treat certain emergency conditions. But for mild and moderate injuries and illness, it is the more cost- effective and convenient option. COME TO THE HOSPITAL WHEN IN DOUBT Providence Saint John's Emergency Department Medical Director Russ Kino, MD, says not to worry too much about a problem not being severe enough to warrant an ER visit, because Providence Saint John's emergency department is set up for immediate triage—sorting patients by priority—on arrival. "We use a process called rapid medical evaluation that expedites care," he says. "We get everything rolling immediately. It can be a very quick process." He also points to the emergency department's very low average wait time of 17 minutes and says that one of the major differences between most hospital ERs and his department is that Providence Saint John's new arrivals see a physician assistant (PA) or nurse practitioner, who records a patient's medical history and may be able to initiate treatment while the patient waits to be seen by a doctor. The emergency department also has a wide range of specialists on call, Dr. Kino adds. "We can have an interventional cardiologist or neurologist here in minutes." He also notes that emergency departments are staffed by a different kind of physician than those you'll generally find at urgent care clinics. "We have a different

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