A head injury involves any bump, blow, or jolt to the head that disrupts the normal function of the brain. Even seemingly minor impacts can cause serious internal damage, such as bleeding or swelling inside the skull. Because the brain is delicate and confined within the skull, delayed or escalating symptoms can signal a life-threatening emergency. This guide provides clear criteria for determining when a head injury warrants an automatic call to emergency services.
Critical Symptoms Demanding an Emergency 911 Call
A call to 911 is automatically required if the injured person exhibits signs of severe neurological compromise or profound physical trauma. Immediate loss of consciousness, even if brief, indicates a significant disruption to brain function. If the person has difficulty staying awake, cannot be easily roused, or slips into unresponsiveness, it signals a severe and potentially worsening condition.
Any seizure or convulsion following the impact suggests abnormal electrical activity or pressure within the brain. Repeated vomiting, especially more than one or two episodes, is a concerning sign that can indicate increasing intracranial pressure. Visual signs of severe injury include pupils of unequal size or pupils that do not react normally to light, which points to direct pressure on the brain.
Further indicators of severe trauma include clear fluid or blood draining from the ears or nose, which may signify a skull base fracture and leakage of cerebrospinal fluid. Obvious physical signs suggesting a skull fracture include severe bruising around the eyes (“raccoon eyes”) or bruising behind the ears (“Battle’s sign”). Other symptoms requiring an immediate medical emergency call are:
- A severe headache that continuously worsens.
- Slurred speech.
- The inability to recognize familiar people or places.
Urgent Warning Signs Requiring Medical Evaluation
Symptoms that do not involve immediate life-threatening collapse still require urgent, same-day medical assessment, typically via an emergency room or urgent care center visit. A persistent or worsening headache, along with mild but persistent confusion or feeling “foggy,” warrants prompt attention. These symptoms can point to a concussion or a developing issue.
Urgent signs requiring evaluation include balance problems, dizziness, or a noticeable lack of coordination. Sensitivity to light (photophobia) or noise (phonophobia) are also common signs. Changes in mood, such as increased irritability, anxiety, or unusual sadness lasting several hours, necessitate a medical check-up to rule out serious injury.
These signs require a medical professional to perform a full neurological assessment. While they generally allow for transport via private means rather than an ambulance, if any symptom rapidly escalates in severity, an automatic 911 call is required.
Immediate Steps While Awaiting Emergency Services
After calling 911, keep the injured person as still as possible to prevent further injury to the brain or spine. If a neck or spinal injury is suspected, avoid moving the person entirely unless they are in immediate danger. If the person is conscious, keep them calm and monitor their breathing and level of responsiveness until help arrives.
If there is bleeding, apply gentle, firm pressure to the wound with a clean cloth or sterile gauze to control blood loss. Do not apply direct pressure if a skull fracture or depression is visible, as this could push fragments into the brain. If the person is vomiting, carefully roll them onto their side as a single unit, stabilizing the head and neck, to prevent choking and maintain an open airway.
Home Monitoring and When Symptoms Reappear
For minor head injuries that did not require emergency care, careful monitoring is necessary for at least 24 to 48 hours following the incident. Delayed symptoms of concussion or more severe injury can emerge during this period. Rest, both physical and mental, is advised, meaning a temporary avoidance of strenuous activity or tasks requiring intense focus.
Delayed signs requiring follow-up care with a doctor include:
- Persistent difficulty concentrating.
- Memory problems or trouble sleeping.
- Unusual mood swings or increased irritability.
- Feeling “not right” or changes in personality.
If any severe signs that would trigger a 911 call—such as repeated vomiting, slurred speech, or inability to wake up—appear during this monitoring period, emergency services must be called immediately.