Is head injuries an emergency?
A head injury can be a medical emergency. Call 911 for loss of consciousness, repeated vomiting, seizures, one dilated pupil, weakness or numbness, clear fluid from the nose or ears, or confusion after a blow to the head. Minor bumps with no warning signs are usually not emergencies.
Whether a head injury is an emergency depends on what happens in the minutes and hours after the blow. The impact itself may look minor while bleeding or swelling builds inside the skull, so the deciding factor is the presence of red-flag signs — not how hard the head was hit.
Call 911 Immediately If You See These Red Flags
These signs point to a possible serious traumatic brain injury (TBI) or bleeding inside the skull and warrant an emergency response:
- Loss of consciousness, even briefly
- A headache that steadily worsens or will not go away
- Repeated vomiting or ongoing nausea
- A seizure or convulsion
- Slurred speech, confusion, or unusual agitation or combativeness
- One pupil larger than the other, or trouble waking up
- Weakness, numbness, or loss of coordination in the arms or legs
- Clear or bloody fluid draining from the nose or ears
- Bruising behind the ears or around the eyes
For anyone who is unconscious, having a seizure, or cannot be woken, call 911 rather than driving them yourself.
Higher-Risk Situations That Warrant an ER Even Without Red Flags
Some circumstances make a serious injury more likely, so an ER evaluation is prudent even when the person seems okay:
- The injury came from a fall from height, a vehicle crash, or a high-speed impact
- The person takes blood thinners (such as warfarin, apixaban, or rivaroxaban) or has a bleeding disorder — these greatly raise the risk of delayed brain bleeding
- Infants, young children, and adults over 65
- Any injury where you cannot reliably monitor the person for the next 24 hours
When a Head Injury Is Usually Not an Emergency
A minor bump — a low-force knock with no loss of consciousness, a small bruise or “goose egg,” and no warning signs — is often not an emergency. These can typically be watched at home with rest and observation. Still watch closely for 24-48 hours, because some symptoms are delayed; if any red flag appears, seek emergency care right away.
Why On-Site CT Matters
The only way to rule out bleeding inside the skull is imaging. Bellaire ER has an on-site CT scanner, X-ray, and full lab, so our board-certified emergency physicians can scan the brain and read results within your visit rather than referring you elsewhere.
For a complete guide, see our head injuries page. Bellaire ER is open 24/7 at 5302 Bellaire Blvd for walk-in care, or call (713) 660-0001 with questions.