Emergency care

Our network of emergency care locations offers short wait times and highly trained, specialized teams. We also offer:

• Access to trauma care in our designated trauma centers
• Comprehensive imaging services and laboratory testing on-site
• Easy transition to critical care units if inpatient hospitalization is needed
• Emergency behavioral health care
• Pediatric emergency departments to treat emergencies affecting children

Freestanding emergency rooms are not attached to a hospital facility. Although freestanding emergency rooms are physically separate from hospitals, they are capable of delivering the same 24/7 emergency services. If you require a higher level of emergency care, you will be transported to one of our hospitals.

Sometimes it can be hard to decide whether or not you should visit the emergency department. Our guide can help you decide:

Chest pain

Call 911 right away if you have chest pain that is crushing or squeezing or comes with any of these other symptoms of a heart attack:

• Discomfort in the neck, shoulder or upper back (especially for women)
• Discomfort in your gut (especially for women)
• Dizziness (especially for women)
• Fast or irregular pulse
• Lightheadedness
• Nausea or vomiting (especially for women)
• Pain that spreads from the chest to the neck, jaw or arms
• Shortness of breath (especially for women)
• Sweating
• Unusual fatigue (especially for women)

Concussion or head injury

You should go to the emergency room if you have hit your head and have any of these symptoms:

• Any period (even briefly) of unconsciousness, amnesia or memory loss
• Feeling dazed or confused
• Seizure
• Slurred speech
• Vomiting
• Worsening or severe headache

Flu, "stomach flu" or severe colds

The flu virus and "the common cold" are very common and do not normally require a visit to the emergency room. However, go to the emergency room with the flu or a cold if you also have:

• Complications, such as signs of pneumonia
• Severe loss of body fluids (dehydration)
• Trouble breathing
• Vomiting that can’t be controlled

Additionally, talk to your doctor about what to watch out for if you are part of a high-risk population — such as infants, seniors, pregnant women and those who have compromised immune systems. Flu and colds may be more serious conditions for you in these cases.

Cold/flu/stomach flu symptoms

Severe stomach pain

Stomach pain is the most common reason patients visit the emergency room. You should seek immediate medical attention if your stomach pain is accompanied by any of the following symptoms:

• Abdomen is hard or tender to the touch
• Dark or black stool
• High fever
• Inability to eat without nausea or vomiting
• Irregular heartbeat
• Pain in your chest, neck or shoulder
• Persistent nausea or vomiting
• Shortness of breath or dizziness
• Vomit containing blood

Side pain

You should seek immediate medical treatment if you have severe pain, especially in your lower right stomach, side or back, or if your pain is accompanied by any of the following symptoms:

• A recent urinary tract infection (UTI)
• Blood in the urine or pain during urination
• Constipation
• Diarrhea
• Dizziness
• Fever
• Persistent nausea or vomiting

Trouble breathing

Seek emergency medical treatment for respiratory distress if you have:

• An inability to speak comfortably and sustain your voice while at rest
• Breathing difficulties accompanied by signs of a heart attack
• Breathing difficulties when you lie flat
• Breathlessness that doesn’t stop after 30 minutes of rest
• Coughing that includes blood
• Noisy, high-pitched or rapid wheezing
• Numbness, especially on one side of the body, or other signs of a stroke
• Severe shortness of breath that affects your ability to function

Other pain in the body and limbs

Severe pain lasting only a few seconds may be nothing to worry about unless it’s recurring. If severe pain persists for more than a few minutes, you should seek medical attention regardless of other symptoms.

Whether or not you have insurance or are able to pay, you will be medically screened, evaluated and stabilized in the emergency room. However, please be aware that pain cannot be treated without a physician order.

In general, the steps of care in the emergency room include:

• Triage and registration — This process is to understand your symptoms, assess your condition and take you to a room, if needed and available.
• Examination and treatment — When it is your turn, you'll receive a doctor's examination and further tests, if needed. Then, your doctor will discuss treatment with you.
• Discharge or admittance — Your physician will determine if you can be released from the emergency department or need to be admitted to the hospital for treatment or recovery.

What to bring to the emergency room

If possible, bring these with you to the emergency room:

• A copy of results from any recent medical tests
• A responsible adult or phone number for someone to contact
• Care preferences and restrictions
• List of known allergies
• List of medications you take
• List of recent medical procedures

When to expect treatment in the emergency room

Those who have life-threatening illnesses or injuries will be the first to be treated in the emergency room. Patients who are seriously ill or unstable will be treated next. All other patients will be seen in the order in which they arrived.

Before you leave the emergency room

Be sure to ask any questions you may have before you are discharged. Please keep all paperwork, instructions and medicines, if you receive any.

After you are discharged from the emergency room

If you have a primary care provider listed in your medical record, we will give them a copy of your visit summary. Contact them after your visit to the emergency room.

We can help you find a primary care doctor if you don't have one.

Getting admitted to intensive care

Sometimes, you or your loved one will need to be admitted to one of our intensive care units (ICUs) after receiving treatment in the emergency room.

Our ICUs are designed to deliver continuous care and monitoring. This is typically for seriously ill or injured patients, including those who are recovering from advanced surgeries or acute cardiac or neurological events, such as a heart attack or stroke.

We also have neonatal intensive care units (NICUs) for infants and newborns as well as pediatric intensive care units (PICUs) for children.

Check the top of our website pages or text "ER" to 32222 to find out the wait times of the HCA Virginia Health System emergency room closest to you.

Note: Message and data rates apply. ER wait times are approximate and provided for informational purposes only.

About our emergency room wait times

Our posted ER wait times are approximate and provided for informational purposes only. If you are experiencing a medical emergency, call 911.

The ER wait times seen on our website represent the time it takes to see a qualified medical professional. This is defined as a doctor of medicine (MD), doctor of osteopathy (DO), physician assistant (PA) or advanced registered nurse practitioner (ARNP).

ER wait times represent a four-hour rolling average that is updated every 30 minutes.