Hospital Or Clinic?

How could I leave last weeks post without giving you all a guide on when to go to the emergency room or a clinic/ private doctor?

Below are some tips to help you decide where to go. (examples included)

Timeline of the problem

If the medical problem started suddenly you may consider going to the emergency department first. Alternatively, if you’ve had the problem for a while but there is sudden change you can consider going to the emergency department as well.

Examples

• You have sudden burning pain in your leg, along with numbness and inability to move it? Accident and Emergency
• You have a chronic cough but all of a sudden you’re having difficulty breathing? Accident and Emergency
• Have a mole on your back that’s now changing colour? Go to the clinic ASAP

Severity of the problem 

Sometimes problems come on us suddenly, but they’re not necessarily severe, or we may have them for a long period of time but the presentation has now changed. The worse the problem is to function with the more urgent it is to get medical attention (in general).

Examples

• Have a headache that feels like a thunderclap and came on suddenly? Accident and Emergency
• Have a headache thats debilitating? Accident and Emergency
• Have an ulcer that’s not healing? Clinic ASAP
• Have an ulcer than now has maggots? Accident and Emergency

Urgency of the problem

Is this a life or death situation? Once it threatens life you need to go to Accident and Emergency.

Examples

• Allergic to seafood and accidentally had some tuna salad? Accidents and Emergency
• Hit your toe and got a blood clot under the skin? Clinic
• Suddenly seeing change in discharge? Clinic- sorry Sexually Transmitted Infections are seen in clinic.
• Found a lump in the breast? Clinic ASAP

Presentation Changes

Many persons have chronic illnesses that they’re living with, so sometimes if anything about it changes you may actually need to go to the hospital. Persons may think that headaches aren’t reasons to go to Accident and Emergency but I tend to disagree. I think it depends. If the pain makes you unable to function then the quality of pain relief you need is in the hospital. However, if the character of the headache changes a clinic visit is often warranted.

Examples

• Your diabetic grandma won’t wake up or seems groggy? Accident and Emergency
• Your asthma attack isn’t settling even with your pump? Accident and Emergency
• When you test you blood sugar its been spiking more than it usually does? Clinic

There is no ‘one size fits all’, a combination is often needed to see where to go. The general rule is that if its acute and affects life or limb the hospital is the place to go. At the end of the day, you can follow your gut.

The hospital has in place a triage system where you will either wait long because you’re the bottom of the list or you will be referred to clinic. In a country where resources aren’t an issue this is fine, but Jamaica’s public health sector is stretched thin so informed citizens are empowered citizens who can help the country function more efficiently.

Samantha C. Johnson