Dr. Wojo. Healthy Living. Simplified.

As the nation debates a new health care plan, there is one critical element to consider - reducing unnecessary trips to hospital emergency rooms (ERs). According to the National Association of Community Health Centers, each year in America unnecessary trips to the ER cost $18 billion. Emergency rooms are designed for those with injuries and illnesses that demand immediate care and/or are life-threatening.

It can be difficult to know whether you should visit a walk-in clinic or an emergency room - following are some guidelines. In the event that you are uncertain whether urgent care is necessary, call your doctor. If you are unable to reach your doctor, then visit the Emergency Room.

Call 911 or immediately go to the Emergency Room if you experience the following.

• Chest pain or pressure that is consistent or persistent, that restricts your ability to move, or is accompanied by pain in the jaw or arms and heavy sweating. If you have a history of heart disease, seek emergency help.

• Shortness of breath. This could be associated with a severe asthma attack or allergic reaction. If you have asthma and your medication does not alleviate symptoms, or the symptoms return shortly - seek medical attention. If your throat or lips swell, you have difficulty walking or talking, or your lips or fingernails are bluish, get help.

• Heavy bleeding that lasts more than five minutes. If you have a cut that is over one-half inch in width or depth, or you can see muscle or bone, you need stitches. Nosebleeds that last more than ten minutes and heavy vaginal bleeding require emergency care.

• Coughing or vomiting blood.

• Blunt force trauma from a fall of greater than 10 feet or an accident could lead to internal bleeding - seek emergency care.

• Poisoning or overdose. This is especially important for children who have ingested poisonous substances. If someone takes prescription or illegal drugs and loses consciousness, seek medical attention.

• Loss of consciousness, for whatever reason, requires immediate medical attention.

• Fever over 103 degrees.

• Sudden, severe headache, especially if you experience neck pain or lose consciousness.

• Severe injuries - broken bones and head injuries.

• Seizures or convulsions.

• Stroke. Symptoms include sudden onset of numbness in the face, arm, or leg - especially on one side of the body; loss of speech; difficulty seeing; dizziness or loss of coordination; sudden severe headache; or confusion.

• Choking.

• Domestic abuse or rape.

• Suicide attempt.

• Animal bites.

• Severe allergic reaction to insect bites. If you experience a swelling of the lips or throat, rapid heartbeat, nausea or diarrhea, dizziness or cramps near the bite, seek medical attention.