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When should I go to the emergency department vs. primary or urgent care?

Jan 17, 2017

Swollen ankle. Sore throat. Chest pains. Sometimes symptoms are clear issues that require emergency room treatment (always chest pains) or an afternoon visit with your primary care doctor (the common cold).

Deciding whether or not a condition requires an emergency room visit isn’t always simple to answer.

An emergency room can be a very busy, crowded place. At St. Joseph’s/Candler, the emergency departments operate 24 hours a day, seven days a week with a highly trained and credentialed emergency staff, with specialists on call for consultation.

So when should you come to the emergency department? We asked Chris Fortin, St. Joseph's Hospital Emergency Department staff nurse.

Possible broken bone?

“Definitely an ER rather than urgent care,” Fortin says . “They are limited in resources as far as radiology and treatments.”

Heart issues?

“If you are having chest pain, don’t mess around,” Fortin said. “In fact, you should call an ambulance for that. Time is muscle. The faster we can fix any problem with the heart, the more heart muscle survivors and the better you are going to be in the long run.”

The flu?

“Treatment for the flu, if it is caught early, (a primary care or urgent care physician) can give you some medicine that will decrease the severity and length of symptoms,” Fortin says. “The flu can turn into something very severe. You could get pneumonia, you could get sepsis, which can be life threatening, so we don’t mind seeing patients with the flu at all, especially the very young and the very old.”

Other examples of when you should come to the ED include: signs of stroke, loss of consciousness or fainting, serious burns, a bite or puncture wound and difficulty breathing.

Other examples of symptoms that can be treated at primary or urgent care include: fever, ear pain, diarrhea, sore throat, vomiting and minor traumas such as bone sprain or shallow cut.

Emergency departments never turn down a patient. More than 136 million people visit a hospital emergency room in a given year, according to the Centers for Disease Control and Prevention. The Candler Emergency Department averages abou t 65,000 patients a year, with a daily average of 170. At St. Joseph’s, the emergency department serves approximately 35,000 patients a year, with a daily average of 100 visitors.

What is triage?

St. Joseph’s/Candler’s emergency departments follow a triage process. Triage is the process of determining the priority of a patient’s treatment based on the severity of his or her condition. Specially trained nurses with at least two years’ experience working in the emergency department sort emergencies, Fortin says. Patients are sorted by an acuity system of rankings 1 to 5 with 1 being someone who isn’t breathing to 5 being someone who came in for a prescription.

Because patients are evaluated to determine the order of when they are seen, you should take this into consideration when determining if your illness is a true emergency or something that can be treated at a primary or urgent care facility.

“If it’s something that you could see your primary care doctor for, but you don’t want to wait, that is a good reason to go to an urgent care rather than an emergency department,” Fortin said. “If it’s something that can’t wait at all, then you probably need to come to the ER.

“Typically patients present for primary care type needs, which is fine,” said Chris Fortin. “We take care of anyone who presents to the ER. It’s a federal law, but it’s also our mission.”

Want to learn more about Emergency Department wait times?  Return back soon to Smart Living for more from Chris Fortin.


If this is an emergency, call 9-1-1 immediately. Emergency Departments are located on both the St. Joseph’s Hospital campus, 11705 Mercy Blvd., Savannah, and Candler Hospital campus, 5353 Reynolds Street, Savannah.

Looking for primary or urgent care? Click here to find a primary care doctor with St. Joseph’s/Candler Medical Group Management. Click here to find location and hours for the SJ/C Immediate Care centers. 

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