Head Injury Red Flags: When to Go to the ER Right Away

Who this is for: Written for anyone who has just hit their head, and for the family member deciding whether to call 911.

Know the difference between “monitor” and “go now”

Most concussion symptoms, such as a mild headache, fatigue, fogginess or light sensitivity, can be followed with your provider over days and weeks. But some symptoms after a head injury can signal bleeding, swelling or another serious problem that needs immediate emergency care.

Knowing the difference can save a life. When in doubt, go to the ER or call 911. It is always better to be checked and reassured.

When in doubt, go to the ER or call 911. It is always better to be checked and reassured.

Symptoms in adults that need the ER now

• A headache that gets worse or will not go away
• Repeated vomiting or nausea
• A seizure
• Slurred speech, weakness, numbness or decreased coordination
• Increasing confusion, restlessness or agitation
• One pupil larger than the other
• Unusual drowsiness, or being unable to be woken
• Loss of consciousness, even briefly
• Clear fluid from the nose or ears

Call 911 if the person is unconscious or getting worse quickly.

Extra caution for some people

Older adults, people taking blood thinners and people with bleeding disorders should be evaluated promptly after any significant head impact, even without symptoms, because their risk of complications can be higher. Infants and young children may show danger signs differently: inconsolable crying, refusing to eat or nurse, or not acting like themselves. Get them seen right away.

Related in this series: Delayed Concussion Symptoms: Why They Show Up Days Later, Concussion Symptoms in Older Adults After a Car Crash and Can You Have a Concussion Without Losing Consciousness?. For the full overview, start with our guide, Concussion After a Crash.

Symptoms can develop later

Dangerous symptoms do not always appear immediately. Keep watching for red flags in the hours and days after an injury, and have someone check on you. Do not drive yourself to the ER with red-flag symptoms. Call 911 or have someone else drive.

Testing is never a substitute for emergency care.

Tell the ER what happened

Explain how the injury happened and when, whether you lost consciousness, which medications you take, especially blood thinners, and which symptoms you have. Bring a family member who can describe what they have seen.

After the emergency visit

If the ER rules out urgent problems but symptoms continue, follow up with a treating provider. They can decide whether standardized testing, such as the mobile testing Braintree performs at your provider's office, would help. Testing is never a substitute for emergency care.

Save this list

Print this page or save it on your phone, and share it with your family. In an emergency, call 911.

Related reading:
How mobile testing works Concussion & TBI testing For patients Service areas what happens at a mobile concussion test eye movement testing after head injury