When you're sick or injured, how do you know if the symptoms or conditions should send you to Urgent Care or the E.R.? As Urgent Care centers become popular, it's important to know where to go.

Emergency Department Director at Ocean Medical Center, Dr. Brad Pulver, explains that if you have symptoms or conditions including an upper respiratory infection, a slight cough or the sniffles, visit an urgent care.

If you're having chest pains, shortness of breath and feel nauseous at the same time...it's a trip to the E.R.

"If you really feel like you're in trouble, if you feel like you're dying, if you're feeling very sick then you should should not only come to the emergency department but call 911 and get here urgently with paramedics or medics who are trained to do some potentially life saving pre-hospital treatment," Dr. Pulver explained.

Medical conditions that warrant a trip to the E.R. include heart attacks, strokes, high fever or troubling flu symptoms.

Dr. Pulver explains that there are certain injuries like serious lacerations and broken ankles that require instruments only an E.R. would have if you require something like blood work.

"We're able to see anything and have the appropriate level of resources to manage things," Pulver said. "For lacerations that need sutchering for example, many primary care physicians don't have the resources in the office to do that. There's a lot of stuff that the (PCP's) just don't have the resources, they can do it, but they don't have the resources. If somebody needs IV fluids, anti-nausea medicine, emergent blood work...you won't get that from your primary care doctor."

Pulver says often times that if you call your PCP and complain of something like chest pains, they may tell you to just go to the E.R.

The Emergency Department at a hospital can be a very busy place to be whether it's from a major event or several people who need treatment for various issues.

Dr. Pulver, says sometimes when things get busy at any hospital, open spots are hard to find.

"If there's not enough capacity in the hospital, than admitted patients end up waiting in the emergency department and that jams up the emergency department and it may cause us to have patients in the waiting room," Pulver said.

He says no E.R. wants to have patients in the waiting room so they always look for ways to get people seated somewhere for treatment, even if it's on a stretcher in the hallway.

When you're in the E.R. being treated for a certain illness or injury, it's important to know what's going on behind the scenes so emotions don't boil over.

Dr. Pulver, explains that it starts with diagnoses and communication with the patient as they search for the appropriate treatment.

"We try very hard to make sure patients get seen quickly and then the E.D. physician will initiate whatever workup and treatment is needed," Pulver said. "There may be a period where the doctor leaves the room for an hour or two while the patient is getting IV fluids, blood work and maybe an X-Ray or a CT scan."

Dr. Pulver says many people aren't aware of what's going on in the emergency department so they make it an appoint to keep them posted on what's going on around them.

Ocean Medical Center in Brick has a sister hospital in Point Pleasant (both through Hackensack Meridian Health) called the Ocean Care Center located right next to the OB Diner on Richmond Avenue.

"That is a full emergency department," Pulver said. "That facility is great for less emergent visits. For trips and falls, lacerations, asthma, rashes, infections and those kind of intermediate complaints it's a great facility for the community."

Ocean Care Center acts more as a Urgent Care than a regular E.D. where you would go if you're having a heart attack or a stroke.

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