A concussion is a mild traumatic brain injury (mTBI) resulting from a bump, blow, or jolt to the head. This movement causes the brain to twist or bounce inside the skull, temporarily disrupting normal function. While concussions are generally not life-threatening, choosing the appropriate medical venue quickly is necessary to ensure proper recovery and rule out more severe injuries.
Symptoms Requiring Immediate Emergency Care
Certain symptoms after a head injury are “red flags” indicating a potentially severe injury, such as a hemorrhage or skull fracture, requiring an immediate visit to the Emergency Room (ER). Loss of consciousness lasting more than 30 seconds or any seizure activity warrants immediate emergency care. A severe or worsening headache that does not improve, especially if described as the worst ever experienced, is a major concern.
Repeated vomiting (three or more episodes) can indicate rising pressure inside the skull, a life-threatening complication. Other serious signs include clear fluid or blood draining from the ears or nose, slurred speech, sudden weakness, numbness, or loss of coordination on one side of the body.
If the person is unable to wake up, is excessively drowsy, or becomes increasingly confused, agitated, or unable to recognize familiar people or places, they must be taken to the ER immediately.
Clear Indicators for an Urgent Care Visit
Urgent Care is the appropriate venue for evaluation when a concussion is suspected, and symptoms are noticeable but stable and non-life-threatening. These symptoms include a persistent, mild to moderate headache that is uncomfortable but not rapidly worsening. Dizziness or a mild sense of imbalance that makes walking slightly unsteady is common.
Patients often report cognitive symptoms like feeling mentally “foggy,” mild confusion, difficulty concentrating, or memory issues. Other indicators include mild nausea that does not progress to repeated vomiting, or increased sensitivity to light (photophobia) or noise (phonophobia). Sleep disturbances, such as sleeping more or less than usual, warrant evaluation.
Seeking evaluation here is suitable when there was no loss of consciousness and the patient is stable, but symptoms require a formal diagnosis and treatment plan. This ensures the injury is “mild” and provides necessary guidance for recovery.
When to Safely Monitor Symptoms at Home
A minor head impact resulting in only a momentary change in feeling can be monitored at home. This includes symptoms that are extremely brief, such as dizziness resolving completely within seconds, or a mild headache that responds immediately to acetaminophen and does not return or worsen. If the individual feels only slightly “off” or dazed for less than an hour and returns to their normal state, intervention may not be required.
Monitoring should only occur if the person is fully awake, aware of their surroundings, and has none of the “immediate emergency care” symptoms. Continuous monitoring for at least 24 to 48 hours is necessary. If any new or worsening symptom appears, medical help must be sought immediately. If initial symptoms do not resolve within an hour or two, or if there is any uncertainty, a medical evaluation is warranted.
What Happens During the Urgent Care Assessment
The Urgent Care assessment begins with a discussion of the injury mechanism and a review of the patient’s current symptoms to determine if the injury qualifies as a mild traumatic brain injury. A basic neurological examination follows, including testing balance, coordination, reflexes, and eye movement.
The provider assesses cognitive function by testing memory, concentration, and orientation, sometimes utilizing standardized tools like the Standardized Assessment of Concussion (SAC). Imaging, such as a CT scan, is typically not performed at Urgent Care, as concussions are non-structural injuries.
If the assessment reveals “red flag” symptoms suggesting a more serious injury, such as increased intracranial pressure, the patient will be immediately referred to the ER. For confirmed concussions, the patient is discharged with instructions emphasizing cognitive and physical rest, along with guidance for follow-up care with a primary care physician.