When should I go to the ER for a swollen face?

When you’re in pain or sick, waiting for your doctor’s office to open up or squeeze you in for an appointment is just not an option sometimes. But how do you know when should you go to the emergency room and when should you to go the urgent care?

When It’s Urgent

Urgent care facilities are equipped to handle more than people assume, and can do so in much less time than an emergency department. These are some common conditions that urgent care facilities can treat:

1. Mild to moderate sprains due to accidents, falls, etc.
2. Moderate back or neck problems
3. Difficulty breathing (mild to moderate asthma, panic attack symptoms)
4. Significant, but not life-threatening cuts or bleeding
5. Diagnostic services, such as x-rays and lab work
6. Minor fractures and broken bones (fingers, toes, etc.)
7. Skin rashes or infections
8. Eye infections/irritation
9. Flu or cold symptoms (fever, vomiting/diarrhea, coughing, etc.)
10. Urinary Tract Infections (UTIs)
11. Minor to Moderate animal or bug bites
12. Persistent, but non-debilitating (see below), or long-lasting headaches/migraines

Learn more about CRHS’s Urgent Care Facility here. 

When It’s an Emergency

Emergencies are classified as life-threatening. Going to the emergency room should be a last resort when an urgent care facility or your primary care provider are not options. Reserve trips to the ER for life-or-limb situations, such as:

1. Severe, persistent chest pains or difficulty breathing
2. Heart attack or stroke symptoms (paralysis, difficulty speaking/understanding speech, radiating pain from chest to jaw or arm, etc.)
3. Head injuries resulting in serious wounds and/or unconsciousness
4. Difficulty speaking or understanding speech
5. Severe internal or abdominal pain
6. Sudden weakness or paralysis in any part of the body (and especially if on one side of face or body)
7. Vaginal bleeding during pregnancy
8. Newborn baby with high fever (babies who are at or less than 3 months old, with a temperature of 100 degrees or higher need to be seen right away)
9. Sudden testicular pain and swelling
10. Severe and persistent vomiting, diarrhea and/or dehydration
11. Serious burns
12. Severe allergic reactions to food (inability to breathe, swelling of face, hands or neck, etc.)
13. Severe animal bites, or toxic or infected bug bites
14. Seizures, without a previous diagnosis of epilepsy
15. Major broken bones (legs, arms, etc. — toes/fingers can normally be treated at an urgent care)
16. Any deep wounds or cuts, gunshot wounds, knife wounds, etc.
17. Loss (or near-loss) of limbs or appendages
18. Sudden/debilitating migraine (begins within a matter of seconds, causes vision or speech impairment, fever, weakness, exhibits unusual symptoms for you, etc.)
19. High fevers resulting in or coupled with: weakness, hallucinations, vomiting, dizziness, drooling, trouble breathing, blood in stool/urine/mucus, pain when urinating, leg swelling, red/swollen/hot area of skin, difficulty swallowing, confusion/agitation, etc.
20. Long-lasting high fevers (103º or higher, lasting more than 7 days)

Learn more about CRHS’s Emergency Department here.

When to Call 9-1-1

If you are experiencing severe, life-threatening situations, it might be necessary to call an ambulance. Paramedics can administer life-saving treatment/stabilization upon arrival and during transit. Ambulances can also ensure that you reach a hospital with haste, and without as much jeopardy to your life or the lives of other drivers on the road. Call 911 when experiencing:

• Heart attack or stroke symptoms
  • Chest pains, pains that radiate from chest to jaw or arm; sudden difficulty speaking, moving or seeing; difficulty understanding speech, etc.
• Faintness or dizziness/blurred vision, high fever, confusion/agitation, etc. (see 19 – High Fevers, above)
• Severe wounds or head injuries of any kind, especially when they cause unconsciousness, dizziness, difficulty seeing, or any other troubling symptoms
• When you cannot safely drive yourself to a hospital or don’t have access to somebody else who can drive you to the hospital
  • Regardless of your ability to drive or be driven by a friend/family member or acquaintance, if you are experiencing any or all of the above symptoms, call 9-1-1 immediately.

Why You Should Know the Difference

You may not think it’s a big deal which one you choose — but it is! Going to the ER when you could go to the urgent care almost always means a hefty medical bill (even with health insurance) and a much longer wait.

Keep in mind, the emergency room is for emergencies — think car crashes, heart attacks, strokes, extremely high and persistent fevers, etc. When you go to the emergency room for a condition that can be handled by an urgent care, you’re going to have to wait until any life-threatening cases are resolved or stabilized first before you’re seen. You would expect the same prioritized treatment if you were facing a life-threatening illness or injury.

Emergency rooms should be reserved for critical conditions or used as a last resort in minor situations if an urgent care isn’t open or located within the area, or you can’t be seen by your primary care physician (it’s the weekend, after-hours, they can’t get you in soon enough, etc.)

What to Do If You Don’t Have Insurance

Many adults will opt for the emergency room for a minor condition when they or their children or other family members do not have health insurance and need medical attention because ERs cannot turn you away or refuse treatment, regardless of your ability to pay. We understand this logic completely, but, for those without insurance, we offer this guide to help you navigate your coverage options.

Please take the time to research your coverage options. Having insurance saves you time, money and frustration in the long run, while keeping ERs open and available for those who need it most.

Read Your Guide to Health Coverage: Getting the Care You Need here.

Puffy face; Swelling of the face; Moon face; Facial edema

Facial swelling is the buildup of fluid in the tissues of the face. Swelling may also affect the neck and upper arms.

This person has noticeable swelling (edema) of the face.

If the facial swelling is mild, it may be hard to detect. Let the health care provider know the following:

• Pain and where it hurts
• How long the swelling has lasted
• What makes it better or worse
• If you have other symptoms

Causes of facial swelling may include:

Apply cold compresses to reduce swelling from an injury. Raise the head of the bed (or use extra pillows) to help reduce facial swelling.

Call your provider if you have:

• Sudden, painful, or severe facial swelling
• Facial swelling that lasts a while, particularly if it is getting worse over time
• Difficulty breathing
• Fever, tenderness, or redness, which suggests infection

Emergency treatment is needed if facial swelling is caused by burns or if you have breathing problems.

The provider will ask about your medical and personal history. This helps determine treatment or if any medical tests are needed. Questions may include:

• How long has the facial swelling lasted?
• When did it begin?
• What makes it worse?
• What makes it better?
• Have you come into contact with something you might be allergic to?
• What medicines are you taking?
• Did you recently injure your face?
• Did you have a medical test or surgery recently?
• What other symptoms do you have? For example: facial pain, sneezing, difficulty breathing, hives or rash, eye redness, fever.

Dinulos JGH. Urticaria, angioedema and pruritus. In: Dinulos JGH, ed. Habif's Clinical Dermatology: A Color Guide in Diagnosis and Therapy. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 6.

Guluma K, Lee JE. Ophthalmology. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 61.

Pedigo RA, Amsterdam JT. Oral medicine. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 60.

Pfaff JA, Moore GP. Otolaryngology. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 62.

Last reviewed on: 1/16/2021

Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.