Recognizing Medical Emergencies

When to Go to the ER?

You know how to handle a minor scrape at home but sometimes the significance of injuries or symptoms isn’t always clear.
Dr. Michael Shapiro, Medical Director of Health First NOW Urgent Care, answers some common questions on when to head to the hospital, when to call a doctor and when to stay home.

How do I know when it is an emergency?
Anyone who experiences the sudden onset of new symptoms which might indicate a life-threatening condition such as a stroke or heart attack should seek immediate treatment in an ER.

“People should become familiar with the capabilities of the ERs in their area,” says Dr. Shapiro. “Some have better resources than others when it comes to handling certain conditions such as heart problems, stroke, pediatric or pregnancy-related problems.”

In Brevard County, Health First Holmes Regional Medical Center is a Level II Trauma Center with First Flight air ambulance able to care for any emergency. The American College of Emergency Physicians has a webpage for the general public with information related to these topics:

Is there a short list of problems that should always be treated as emergencies?

  • Patients with sudden symptoms that might be related to stroke (such as weakness on one side, difficulty with speech or vision) should go to the closest ER with a designated “Stroke Center.”
  • Persons developing acute chest pain, especially if accompanied by other symptoms such as shortness of breath, neck/jaw/arm pain, or nausea may be having a heart attack and should be evaluated in an ER with access to advanced cardiac capability (such as the Heart Center at Health First Holmes Regional Medical Center).
  • Women who are pregnant and having bleeding or pain may also have an emergency medical condition and should go directly to the ER, preferably one that is in a hospital that has an obstetrical unit.

What are common issues seen at the ER that could be treated elsewhere?
All urgent care centers can treat minor conditions such as:

  • Respiratory and urinary tract infections
  • Gastrointestinal disorders
  • Minor trauma (sprains/strains, lacerations, animal bites, skin infections, etc.)
  • Many can provide intravenous fluids in order to treat dehydration

“Some centers, like Health First NOW have access to advanced lab and diagnostic imaging (such as CT scan) that previously were only available at a hospital,” he said. “This allows us to diagnose and treat conditions like kidney stones, diverticulitis, blood clots and many other problems. We are also able to provide intravenous medications and other treatments which previously would have to be given at
a hospital.”

What are the disadvantages of visiting an ER unnecessarily?

Most people know that a visit to the ER can be costly, even if covered by insurance. Wait times can also be long if you do not have a life-threatening emergency. Additionally, the ER experience and environment is often unfamiliar and anxiety-producing and the ER staff may not be familiar with the patient’s medical history, medications and allergies, especially if there have been any recent changes.

“At Health First NOW, especially for patients with a Health First primary care doctor, we have the advantage of being able to see the patient’s electronic medical record (EMR),” Dr. Shapiro said. “The EMR enhances patient safety by warning of inadvertent drug interactions and allergies. Everything we do is visible to the patient’s regular physician as well, which enhances follow-up care.”

When should I call 911?

911 should be accessed when someone is having acute symptoms which might suggest a stroke, seizure or cardiopulmonary problem (chest pain, loss of consciousness, difficulty breathing.) Patients who fall from a height may have a spine injury and require immobilization to prevent further injury. People should not call 911 just to “skip the waiting room” as that endangers others that may truly need the service.

What should I do if I’m unsure?

Most health insurance companies provide a 24-hour nurse advice line to assist patients in making the decision about where/when to seek care depending on the nature of the problem. For Health First Health Plans the number is (800) 308-5848. Everyone should have a primary
care provider that they can contact to seek guidance.

Health First NOW is a convenient and affordable urgent care center run by Health First. Open 365 days a year with four locations (Melbourne/Gateway, Malabar Road, Cocoa Beach and Indialantic.) You can also schedule an appointment online for Health First’s Urgent Care or ERs online and minimize the wait time or view the hours of operation and addresses at