by Dr. David Scordino

Knowing the best place to seek care for your family can be tricky. Whether you should head to the emergency room, an urgent care facility or call up your primary care physician or pediatrician is a question many have wrestled with. This is an especially difficult question when it comes to seeking essential care during a pandemic.

We sat down with Dr. David Scordino, Medical Director of the Department of Emergency Medicine here at Alaska Regional Hospital to provide some clarity on where and when to seek the care you need!

How do I know whether to go to the emergency room, an urgent care facility or my primary care physician?

Primary care is the best place to get long term care. While there are some emergencies related to chronic medical conditions such as diabetic ketoacidosis and hypertensive issues, most of the time your primary care provider is best served to help with your blood pressure, blood sugar, refills of medication, chronic neck, back or joint pain or other long-term care. Minor or worsening of heart conditions, asthma, COPD and similar disorders are also well suited to be managed by your primary care provider.

Urgent care is designed to handle minor illness and injuries after hours or other times when your primary care provider is not available. Ailments such as sprained ankles, minor cuts and mild respiratory or diarrheal illness are very appropriate for most urgent care facilities.

The emergency department is the best place for possible emergencies that don't need a call to 911. The ER is open 24 hours a day, seven days a week, 365 days per year. It is here to handle the same issues as urgent care, but the ER is also well equipped to handle concerns for blood clots, strokes, heart attacks, appendicitis and many other life and limb threatening illness and injuries.

The ER is not as well equipped to address long term management of chronic medical conditions. While we may be able to address temporary concerns about a person's blood sugar, pain or blood pressure; a continued relationship with a primary care provider is critical to long-term care and management of your overall health.

What are the warning signs and symptoms that warrant an ER visit?

There are many diseases, conditions or situations that can be life or limb threatening which would require an emergency room visit. These conditions present themselves differently in each patient, which makes it hard to create an all-encompassing list of symptoms that require the ER.

A few examples of situations that usually require an ER visit or a 911 call, include:

  • Significant chest pain or discomfort; especially if you have risk factors for blood clots, heart attacks, are middle aged or older.
  • Severe shortness of breath
  • Coughing up or vomiting blood
  • Severe or worsening abdominal pain and/or inability to keep food or liquids down
  • Abrupt onset of weakness, numbness, change in speech or vision
  • Significant injury resulting in severe pain, weakness, numbness or poorly controlled bleeding
  • Stabbing or gunshot wounds
  • Partial or completion amputation of a limb
  • Intentional or unintentional overdoses
  • Sudden dizziness or fainting
  • Fever in children under 3 months old
  • Severe or sudden onset headache

Remember if you are experiencing signs of stroke or have other symptoms that require immediate medical attention call 911.

What is the difference in care I will receive from an ER versus an urgent care or other physician?

All of the emergency department physicians at Alaska Regional Hospital are board certified in emergency medicine. This specific skill set and training makes us uniquely qualified to identify and manage life or limb threatening medical conditions. The emergency department also, offers additional resources for care, such as labs, ultrasound and CT scans among many others which may not be available at an urgent care facility.

Urgent care facilities are well-designed to manage certain medical conditions. However, there are often limitations to their evaluation and care capabilities.

The cost of care at any facility greatly depends on your health insurance, co-pay and deductible. That being said, sometimes waiting to seek emergency care or going to another facility first can result in a delay to definitive care. For example, waiting to seek care with signs of a heart attack or stroke can result in additional harm or even death.

In the proper care setting, the possible financial implications are worth the potential improved health outcome for you and your family. Additionally, it’s important to know that you may be referred to an emergency department for further care after visiting an urgent care or physician's office if the provider does not believe they are equipped to properly help or evaluate for a life-threatening condition.

If you believe you or your family member is suffering from an acute life or limb threatening condition, you should seek emergency medical attention first at the local emergency department to quickly get the care you need without delay.

Is it safe to come to the emergency room during the COVID-19 pandemic?

Absolutely. You should not delay the essential care you need because of the COVID-19 pandemic.

While our area has not seen many COVID-19 hospitalizations to date, Alaska Regional Hospital has continued to put in universal precautions to keep you and your family safe. The hospital is screening all patients and visitors before they enter the hospital, has implemented universal masking of all colleagues and visitors, implemented thorough cleaning procedures and has minimized or eliminated interaction between patients or visitors. Further, our fast ER wait times keep you out of the waiting room, getting you the care you need and back home quickly. These universal precautions make the emergency room arguably as safe as visiting the grocery store.

The most recent data released by the state of Alaska suggests that initial concerns about increased mortality related to some not seeking care for non-COVID diseases has not yet been realized. However, this has not been the case in COVID hotspots like New York and New Jersey. There is growing concern that fear of seeking care will result in delays in diagnosis for cancer, reduced vaccinations resulting in measles outbreaks and additional morbidity from delayed care for chronic medical conditions. Not only are emergency rooms and other healthcare facilities safe, it is critical that you continue to diligently address health emergencies and health maintenance during this time.

Learn more about emergency care at Alaska Regional Hospital and see current ER wait times by visiting: