By Jill I. Ratner, MD | Pediatrics
Karen left work late to pick up her 3-year-old son, Billy, from day care. A staffer there had called Karen in the afternoon to let her know Billy was experiencing some upper respiratory distress, seemed cranky, kept rubbing his ears, might even have a slight fever.
She measured Billy’s temperature upon arriving home. It was nearly 100 degrees Fahrenheit. The fever was of some concern to Karen, but more disconcerting was the pain that Billy said he felt in his left ear.
Karen checked the time; it was now after 6:30 p.m. She thought the pediatrician’s office was closed and was afraid Billy’s condition might worsen overnight. She would feel better if a doctor examined that ear tonight. Her initial reaction was to take him to the local hospital emergency department, but, instead, she opted for another course of action. She remembered that an urgent care center had just opened in the neighborhood. It offered evening hours.
She waited less than a half hour for Billy to be seen by an urgent-care physician. The doctor examined Billy’s ears and diagnosed the problem as acute otitis media – an ear infection — on the left side. He explained that not all ear infections need to be treated with antibiotics, and given that Billy didn’t seem very uncomfortable, his recommendation would be to treat with ibuprofen and follow up with Billy’s pediatrician. He advised Karen to contact her pediatrician the next day for follow-up.
In this scenario, Karen made the right choice – taking her child to an urgent care center rather than a hospital emergency department, many of which are overwhelmed by patients seeking help for non-life-threatening problems. In an emergency department, waits are often hours-long and costs high.
A study published in Pediatrics in April 2016 determined that the three most common childhood diagnoses in both the urgent-care and emergency-room settings are upper respiratory infections, fever and otitis media – all conditions rated as being of “lower severity.” The true difference, however, is cost, with hospital emergency charges being as much as five times higher than those of urgent care centers for treating the same conditions, researchers said.
Because illness or injury can occur at the most inconvenient times, knowing what to do in advance is the best defense. Here are five tips for planning ahead:
Contact your pediatrician’s office and find out how you can reach your doctor during off-hours. Obtaining advice from the provider who knows most about your child’s health is the best first step, says the American Academy of Pediatrics. At CareMount Medical pediatric offices routinely offer early morning walk-in hours, evening and weekend extended hours.
Keep Records: Keep a record of your child’s medical history, including allergies and past medical procedures; bring the information with you when seeking treatment.
Take your child to an urgent care center if you cannot get to see your pediatrician for such immediate problems as: ear pain/infection, upper respiratory illness with fever, persistent sore throat, infectious conjunctivitis (pink eye), gastroenteritis (some vomiting and diarrhea), or minor injuries, like sprained ankle or laceration.
Go to a hospital emergency department if your child has a gaping wound; is under 2 months old and develops a fever of 100.4 degrees Fahrenheit or higher; suffers possible broken bones or traumatic brain injury with loss of consciousness; has a seizure; is gasping for air, in severe pain or seriously dehydrated.