Urgent Care or Emergency Room: 6 Ways To Decide Which Is Best?

A two year old girl coming to say goodnight to her daddy runs into the bedroom, loses her footing as two year old children often do, and lands face first on the corner of the wood frame bed.

What do you do?  What do you do?  (Yes, I wrote that thinking of Keanu Reaves saying that in ‘Speed’).

Unfortunately, this situation presented itself as a real situation for us last week as our daughter did that.

I was across the room so I saw the entire thing happen but was too far away to do anything about it except watch as I saw her land right on the bed.  Often times when kids fall, their reaction comes from how their parents act.  I knew that this was not going to be one of those situations.  Her reaction was going to come right from the pain I knew she was feeling.  I screamed at the same moment that she started wailing.  My wife ran out of another room and met us in the hall.

I knew that two people would be best to handle this.  Our daughter would need us both, and I immediately knew that one of us should comfort and one should assess.  My wife made it clear who would be doing what when she said “You look, I can’t look.” Up until then, I hadn’t given it a close look, though keep in mind only a few seconds had passed.

I took a look to see where she had hurt herself.  Though there is no ‘good’ place for a kid to land on their face, the fact is there are probably really bad places, such as:

  • Teeth – I could imagine few things hurt more than having teeth knocked out, loose, or broken.  Thankfully this didn’t happen
  • Nose – I say this with maybe a little prejudice, but our daughter is the most beautiful little girl in the entire world, and a nose like a prizefighter is a look that simply wouldn’t suit her in any way.
  • Eye – I had a friend who was hit square on the eye with a softball, causing significant damage to his orbital bone.  He came out fine but it required surgery and it was a painful recovery.  His vision was fine, but there’s risk there, too.  Again, her eyes were spared.

She took it right on the forehead, slightly above her eyebrow.  I looked at it and three thoughts popped into my head at once:

  1. That’s a deep cut.  It was about an inch wide and definitely split open.
  2. For as deep a cut as that is, I can’t believe it’s not gushing blood.  Without going into too much detail, there was blood but it wasn’t running down her face. It was basically filling the cut very slowly.
  3. She’s going to need stitches.

We grabbed some paper towel to put over the cut, and I ran down to get an ice pack to put on it.  After looking at it again, I got more paper towel and some peroxide and cleaned it a bit.

I have to give a shout to our son, who at age four was old enough to know that this was a serious situation, and he stood there quietly, very concerned for his little sister.  He came over and gave her a little kiss trying to comfort her.

By now a couple of minutes had passed, and it was time to move from handling the immediate situation to looking at the next steps.  The next steps would, I knew, involve taking her to get stitches.  I told my wife (she still wouldn’t really look) and we started talking about what to do.

The questions we both agreed needed answering were:

  • Where would we take her?  Urgent care or emergency?
  • Who would go?  Did we all need to go or should one of us stay back with our son?

By this point, the bleeding had pretty much stopped.  She had started to calm down.  I could also see that my son, while very concerned and brave for his sister, was also very shaken up.

Based on these factors, I made the recommendation that my wife stay back and that I take her to an urgent care.

My wife wondered if we should consider the emergency room. Here are the decisions we used to decide emergency room vs. urgent care:

  • mb-201403emergencyLess busy – When I called the urgent care to make sure they did in fact do stitches, they indicated it was not busy.  I didn’t call the ER but I know they can be busy.
  • Location – The urgent care is 5 minutes away.  The ER is about 10 minutes, plus parking and all that.
  • Price – The urgent care co-pay is $50.  The ER co-pay is $150.
  • Is It Urgent or Is It An Emergency? – I listed this one lower in the list, but more as an anticipation builder.  In all honestly, this was the top factor.  Based on the fact that she had not damaged herself in a ‘really bad’ area, and that she had already stopped bleeding, I felt it was an urgent situation.  But it wasn’t an emergency.
  • Reputation – I had personal reputation and well as public reputation for the urgent care.  I had been to this urgent care for a poison ivy outbreak a few years ago and was well taken care of.  I’d also just seen on a community driven Facebook page, where someone asked for recommended urgent cares, where the one I wanted to take her got a lot of positive mentions.
  • Risk – After talking with the urgent care, I knew that there were two variables that could provide risk, where if either came to pass, we’d have to go to the emergency room anyways.  The first was that if the urgent care felt the cut was too close to her eye.  The second is if my daughter would not stay still, as they did not have restraints.

Add all this together, and urgent care was the decision.  I thought the wound was far enough from her eye where they would be OK to do it, and I know that our daughter is a trooper.  In the end, my wife  agreed.  And since our daughter had calmed down, and was not bleeding, my wife and I felt it would be just fine for me to take her.  We told her not to touch her boo-boo, and set out on the way.

Fast forward 90 minutes after she took her fall, and she was back home, with eight stitches in her forehead, and heading to bed.   Though our daughter cried a lot, the urgent care said that she did great and was very brave. In fact, a minute or so after the stitches were done, my daughter was done crying and was already busy sweet talking the nurse into getting some extra stickers!

14 thoughts on “Urgent Care or Emergency Room: 6 Ways To Decide Which Is Best?”

  1. It would have been a very hard decision to make. Glad she is doing well. I am so glad we don’t have to worry about cost here in Australia, emergency is free, as are a lot of doctors.

  2. Having a child hurt themselves, especially watching it happen, is a nightmare for a parent. Sounds like you and your wife handled it very well. In times like these, many people (including my wife) tend to throw all thoughts of cost effectiveness out the window and simply default to the greatest level of care. Even though you were very concerned for your daughter (very glad to hear she is doing well!), kudos to you for assessing the situation with ALL factors and making the right call.

    • I definitely wanted the greatest level of care, but all things considered, I felt the urgent care and ER would probably come out equal. I estimated I’d have a longer wait at the ER, and when you’re talking about closing a wound, I know time is important.

  3. I’d bet that about half to a third of all toddlers end up with stitches in their heads! That sounds very familiar – my brother did something similar when he was just under two and I watched the whole thing. I was freaked out, but my mother had wigged. Thankfully, my step-dad was calm enough to take care of the whole situation. Good thing your Urgent Care is close by and was able to get her in right away. Now, just keep your daughter out of the sun so it doesn’t scar!

    • Yes, lucky it didn’t happen mid-summer. We’ll have 2-3 months before we hit peak summer which should allow for considerable healing and scar prevention. I think we’ll still have to be very dilligent about keeping lotion on her to keep the UV rays from damaging the new tissue.

  4. Ugh. That is terrifying. I remember when my little brother decided he could scale the TV (I’m 10 years older than him) when he was 3. He sure did make it almost to the top, before he pulled the TV down on himself. And somehow he managed to do this all in a span of about 15 seconds, between when my friends and I noticed what he was doing and we all jumped up to try to grab him. The TV came down right on the top of his skull. It was ridiculously scary.

    On the brighter side (?), I tell him he has something to blame for how weird he is now… that is definitely more a sibling than a parental take on it though.

  5. Oh my gosh! I’m so glad she’s doing well!! Sounds like you did a great job managing to stay calm and thinking through the situation rationally. I get faint at the sight of blood, so I don’t know what I would have done if I was in your shoes. I almost passed out when my mom got a bloody nose once.

    That’s a great point about urgent care probably being less busy. Fortunately I live near an urgent care myself. It’s comforting to know that’s always an option. Phew I’m glad you were able to get her to a doctor quickly and that everything is okay now!

  6. Your wife definitely handled it well. It can be tough to keep your composure and make good decisions when it comes to the immediate health of your child. An urgent care clinic can be a a good choice if the condition is not severe or life threatening.

  7. Wow, I would have freaked out. I’m glad she is feeling much better now, poor thing. I’m glad I read this because it’s not something that I’ve thought about. I’m going to find out where the nearest urgent care facility is to us so that I don’t have to think about it in an emergency.

Comments are closed.