the c5b strategy patients and parents should know

When you’re sick or hurt, sometimes it’s hard to know what to do. Do you rush to the emergency room (ER)? Try urgent care? Or stay home and try telehealth or simply hope whatever you’re going through passes? 

Andrew Perry, M.D., a pediatrician, emergency medicine doctor, and HMSA medical director, has a simple strategy. It’s called C5B and stands for chest (the “C”), brain, breathing, belly, bleeding, and bone (the five “Bs”). It’s a quick way to remember six symptoms that shouldn’t be ignored. Think of it as a mini body check from head to toe. 

Chest
Chest pain is usually the first thing people think of when they see someone rush into the ER — and for good reason. “If you suddenly feel severe chest pain and don’t know why, don’t wait,” says Dr. Perry. Even if it turns out to be nothing serious, it’s always better to get checked. 

Brain
The next step is to focus on your brain. “If you get the worst headache of your life, or one that hits you suddenly like a thunderclap, that’s not normal,” Dr. Perry says. He also recommends looking for the following indicators: 

• Trouble talking.
• A droopy face.
• Weak arms or legs.
• Feeling off balance or feeling confused.

“Those are big red flags,” he says. “That’s when you call 911 or head straight to the ER.”

Breathing
The way you’re breathing can also be an indication that something isn’t right. “If an allergic reaction starts to cause swelling around your mouth or tongue, tightness in your throat, or if you’re gasping for air or wheezing badly, don’t try to tough it out,” Dr. Perry says. “Trouble breathing is always serious. That warrants a visit to the ER.”

Belly
Now, move down to your stomach. “If you have severe belly pain that won’t go away, that’s another reason to go to the ER, especially if you can’t reach your primary care provider (PCP),” says Dr. Perry. “ER doctors can run tests and scans quickly to figure out what’s going on.”

This also includes possible poison exposures. The Hawaii Poison Center is free and available 24/7 at 1 800-222-1222 if you ever need guidance. 

Bleeding
Blood is a pretty big indicator that something is wrong. “If you’re bleeding a lot and it won’t stop, if the blood is spurting, or if you’re seeing a lot of blood when you use the bathroom, that’s not something to ignore,” says Dr. Perry. “Get to the ER ASAP.” 

Bones
Feeling something in your bones? Don’t ignore it. “If something looks bent or twisted, or if it looks like the bone might poke through the skin, that’s more than a simple injury,” says Dr. Perry. “That’s another reason to head straight to the ER.” 

When it’s not an emergency
Not every ache, pain, or sniffle belongs in the ER. Lucie Tam, RN, HMSA’s clinical coordinator for Quality & Performance Improvement, says patients have more options than ever and using them can save time, money, and stress. “The ER is always there,” she says, “but if you really don’t think you’re that sick, there are easier ways to get care.” And choosing urgent care helps keep ERs available for people who really need them. 

When urgent care makes sense
According to Tam, urgent care is a good option when you need help quickly, but it’s not life-threatening. She recommends urgent care for: 

• Back pain.
• Conjunctivitis (pink eye).
• Headaches, dizziness, or migraines.
• Minor cuts that may need stitches.
• Minor fractures without open wounds.
• Removing small, nondangerous objects from the body.
• Sore throat.
• Sprains, strains, and small injuries.
• Urinary tract infections.

“If you can’t get an appointment with your PCP or their office is closed, try urgent care,” Tam says.

When to see your doctor or try HMSA’s Online Care
For minor issues, your PCP is still the best first stop. “Many offices even have after-hours numbers so you can talk to a provider. If that’s not available,” Tam says. “HMSA’s Online Care^® is a lifesaver. You can talk to a provider anytime, 24/7, right from home.” 

Your PCP or Online Care is perfect for: 

• Cold or flu symptoms.
• Ear pain or mild fever.
• Feeling stressed, anxious, or just not yourself.
• Mild allergic reactions.
• Mild back pain or strains.
• Small cuts or scrapes.

Weigh your options
The ER provides vital care, but it’s not always the best first stop. If you’re not seriously ill, urgent care or your PCP can save you time and money, reduce stress, and keep the ER available for people who really need it. “Emergency rooms see everything, so they have to prioritize the sickest patients first. That means minor symptoms might have to wait,” Tam says. “Using urgent care or telehealth with your PCP for these issues helps make sure you get the right care at the right time.” 

But, even with these options, Tam stresses one key thing: Trust your instincts. “Medicine is subjective. Pain tolerance and how sick you feel are different for everyone,” she says. “If you really feel something is wrong, go to the ER. Don’t hesitate.” 

Be ready
When you need care, be prepared! To find an urgent care clinic near you, go to hmsa.com, click Find a Doctor, choose your plan, and look for an Urgent Care Clinic under Specialties and Facility Types.

Check your Guide to Benefits to see if it covers HMSA’s Online Care so you can register before you need it. 

Prep for the future
You’ll be ready for any kind of emergency with these articles:

reducing emergency department visits
When it comes to health care, many individuals who lack resources believe they have few options. So even minor issues often lead them to the emergency department. Learn what Waikiki Health is doing to address this problem with its Emergency Department Diversion Program.

is it a dental emergency?
It’s hard to know what constitutes a dental emergency, but you may need a visit to the emergency room, a routine visit to your dentist, or after-hours consultation and care. Being prepared may save your smile! 

last-minute travel: healthy tips on the go
Business or family could call you away from the Islands with no notice and very little time to prepare. Here are some tips to help you stay as healthy as possible during last-minute travel. 

hurricane food gone healthy
Prepare for hurricane season by building a disaster supply kit with enough food and water for at least 14 days. Find out what you should include. 

^{Amwell is an independent company providing hosting and software services for HMSA’s Online Care platform on behalf of HMSA.}