Urgent Care vs. Emergency Center: Where to take your child for immediate and unexpected needs

• The daycare calls you to pick up your 6-month-old daughter because she has been fussy all day and recently spiked a 102-degree fever.
• Your toddler has been crying all weekend about an earache after spending all day at the water park.
• Your kindergartener falls awkwardly on the trampoline at her cousin’s birthday party and is now refusing to walk.
• Your teenager sustains a cut to his forearm from a rusty nail after reaching behind the workbench while helping clean out the garage.

As parents, chances are that many of us have experienced something similar to one of these stress- inducing scenarios. Along with the initial concern for your child’s well-being often comes the frustration and uncertainty of how to plan a last-minute, same-day medical evaluation. Talking to your pediatrician is always a great option, but what happens when it occurs after hours or on a weekend, or if your pediatrician is already booked for the day and you need your child assessed right away? During those moments, your choice often boils down to the emergency center or an urgent care clinic. So how do you make the best choice for your child? The decision can feel confusing, particularly when dealing with infants and young children.

For most problems, Think: Urgent Care

Did you know that the majority of common pediatric illnesses and injuries can be evaluated and managed at an urgent care clinic? Children with fever, cough, sore throat, ear pain, pink eye, vomiting, diarrhea, urinary tract infections, rashes and allergic reactions are treated every day in our clinics. In addition, minor cuts, minor burns, sprains and even simple fractures can be diagnosed and treated routinely in our setting.

Texas Children's Urgent Care has 11 locations in the greater Houston area and two locations in the Austin area designed to provide a cost-effective alternative to the emergency center. Each one is staffed by certified pediatric providers who are trained to diagnose and treat these common pediatric illnesses and injuries. Our community locations are open from 12-10 pm on weekdays and 10 am-8 pm on weekends, and our three Houston locations situated at the Texas Children’s Hospital campuses operate from 10 am-10pm. If you are visiting one of our hospital locations, you can walk in directly to our urgent care clinic and do not need to check in with the emergency center first.

Walk-in patients are welcomed at all our locations, but as an added convenience, you can also choose to visit our website to reserve an available time slot later that day for your child to be seen. A common misperception is that you must have an established Texas Children’s pediatrician to visit our facilities, however your child does not need any prior visits to a Texas Children’s facility to be evaluated at a Texas Children’s Urgent Care clinic.

And unlike the emergency center which frequently encounters life-threatening scenarios that must be prioritized ahead of other patients who were already waiting, our urgent care clinics are typically able to evaluate patients in the order in which they arrive. As a result, many of our urgent care visits can be completed within an hour and any required prescriptions are promptly transmitted to the pharmacy of your choice with a summary of the visit sent to your pediatrician’s office.

Various resources are available to evaluate your child including onsite X-ray services to assess extremity injuries for fractures, and our providers and clinical support staff are equipped to perform minor procedures such as splinting and laceration repair to manage a variety of injuries. Referrals to a specialty clinic for follow up for these types of issues can be scheduled if needed and your child’s appointment date and time can often secured prior to departing the clinic. We perform common rapid testing such as strep and urine tests, and additional testing is not typically required in our setting to establish a diagnosis and a treatment plan. Fewer than 3% of patients seen in our urgent care clinics require an immediate referral to the emergency center for further management after their urgent care assessment.

Convenient Telemedicine Options are available

In addition, if you find yourself unable to bring your child to the clinic, but are still looking for treatment recommendations, Texas Children's Virtual Care provides another great option for you, all from the comfort of your own home! Visit our website or call 832-822-2222 to schedule a same day telemedicine appointment or simply join the virtual queue to discuss your concerns with our expert pediatric healthcare providers. For sports injury related concerns, there are even opportunities on most weekday afternoons to schedule virtual visits with our highly trained Texas Children’s Sports Medicine physicians.

You can find more information and schedule a visit with our Texas Children’s Urgent Care and Texas Children’s Virtual Care services on our website at Texas Children's Urgent Care.

Watch out for these warning symptoms that should steer you towards the emergency center

While most common illnesses and injuries can be managed in the urgent care, there are still some red flag symptoms that would likely necessitate an emergency center visit. Here are some general examples of concerning signs in children to look out for:

• Signs of severe respiratory distress:
  • Persistent and excessive rapid breathing
  • Signs of labored breathing such as flaring of the nostrils, retractions of the chest wall muscles in between the ribs with each breath, or the use of stomach muscles to breathe
  • Persistent noisy breathing sounds such as wheezing or grunting
  • Color changes such as a bluish tint to the lips, skin or fingertips
• Signs of severe dehydration resulting in some combination of the following:
  • Dry and sticky mouth and tongue
  • Crying without tears and/or sunken eyes
  • Lack of urination for more than 12 hours (or less in young infants)
  • Cold blotchy skin
  • Dizziness, confusion or near-fainting episodes in older children
• Signs of neurologic impairment:
  • Excessive sleepiness or difficulty arousing
  • Excessive irritability or inconsolability, particularly in infants
  • Sudden changes in vision or speech
  • Seizures
• Signs of potential injury complications:
  • Injury to the arm or leg associated with an abnormal shape of the injured area suggesting that a broken bone is misaligned
  • Head injury associated with loss of consciousness, persistent confusion or sleepiness, neck pain, or numbness and tingling to the arms or legs
  • Large cuts that won’t stop bleeding after applying direct pressure, or gaping cuts to the face in younger children who may need sedation or additional behavioral support while the laceration is being repaired

This list is not all-inclusive but highlights some of the more important overall considerations when determining your destination. In addition, if your child has an established underlying chronic condition such as sickle cell disease, diabetes or congenital heart disease that may render them more vulnerable to complications from a routine illness, then you should consider seeking care in the emergency center or consulting with your specialist before visiting the urgent care clinic.

Each of our four Texas Children’s Hospital campuses (Texas Medical Center, West Campus, The Woodlands and North Austin) has an emergency center operating 24 hours a day, 7 days a week that is equipped to manage the most serious injuries and illnesses; and each of them offers a much broader array of medications, laboratory testing, diagnostic imaging and ancillary services than you could receive at an urgent care clinic.

For more information regarding our Texas Children’s Hospital Pediatric Emergency Centers, visit our website: https://www.texaschildrens.org/departments/emergency-center.