Taking an anticoagulant, commonly referred to as a blood thinner, introduces a serious risk following a fall. These medications reduce the blood’s ability to form clots, which prevents dangerous blockages like stroke. However, this action significantly elevates the potential for uncontrolled internal bleeding, even from a simple bump. The greatest concern is a bleed inside the skull, known as an intracranial hemorrhage, making immediate and ongoing observation necessary after any fall.
Immediate Steps After the Fall
The moments immediately following a fall are crucial for stabilizing the situation and determining the need for emergency services. First, assess the scene and the individual to ensure they are in a safe environment before attempting movement. If there is external bleeding, apply firm, direct pressure to the wound to encourage clot formation, recognizing this may take longer due to the medication. Do not rush the person to stand up, especially if they report pain or if the fall suggests a fracture or head impact. If heavy, persistent bleeding cannot be controlled, or if there is any doubt about the severity of the injury, call for emergency medical help immediately.
Emergency Warning Signs: When to Call 911
Acute physical and neurological changes following a fall indicate a life-threatening internal injury, often a severe bleed in the brain, requiring an immediate call to 911. Seek emergency medical attention for any loss of consciousness, even if momentary. Clear indications of a serious neurological event include severe disorientation, sudden confusion, or inability to recognize familiar people. A persistent and severe headache, especially if described as the “worst headache of one’s life,” should be treated as an emergency. Other signs include the sudden onset of neurological deficits, such as weakness or numbness in a limb, difficulty walking, trouble speaking, seizure activity, or repeated vomiting.
Monitoring for Delayed Symptoms
Internal bleeding, particularly within the skull, does not always present with immediate symptoms, creating a period of heightened risk that lasts for 48 to 72 hours following the fall. Observation is necessary even if the initial medical evaluation showed no immediate damage, because a slow bleed can worsen over time. This monitoring period is relevant for people taking older anticoagulants like warfarin, or those taking aspirin concurrently with any blood thinner. Subtle but persistent changes should prompt a call to a healthcare provider for urgent care, even if 911 is not warranted.
Signs of Worsening Condition
These signs include increasing drowsiness, a mild headache that lingers or worsens over hours, or a change in the person’s normal personality or behavior. Other concerning symptoms are persistent nausea or vomiting that occurs more than once, or new issues with vision, such as blurriness or double vision. Additionally, keep a close watch for new or expanding areas of bruising on the body, especially in locations far from the impact site, as this suggests ongoing bleeding into the tissues.
Communicating with Your Healthcare Team
After any fall, the medical team needs precise information to assess the risk of complications and determine the proper course of action. Be prepared to state the exact name and dosage of the blood thinner that was taken, such as apixaban or rivaroxaban, and the precise time the last dose was administered. This information is necessary for providers to gauge the level of anticoagulation present in the body and decide if a reversal agent is needed or appropriate. A detailed description of the fall itself should also be provided, including where and how the person landed, and whether the head or torso was struck, as this helps medical professionals focus their examination and imaging. Following the acute event, schedule a follow-up appointment with the prescribing physician to review the incident and discuss whether the current medication regimen needs a temporary adjustment to balance the risk of future clots against the immediate risk of bleeding.