So you’ve fallen off of your horse and hit your head – do you need to go to A&E?
(I remember being a stubborn child, refusing to go to A&E after some nasty falls when I was younger)
The answer is YES if you suffer any of the following:
- Loss of consciousness
- Altered level of consciousness (a GCS score of 14/15 or less – see image).
- Seizure since injury
- Suspicion of skull fracture:
- Clear fluid running from the ears or nose
- Bleeding from one or both ears
- Bruising around eye or ear without damage
- Evidence of shock
- A bleeding or clotting disorder or anti coagulant medication
- Previous brain surgery
- More than one episode of vomiting in adults (3 or more in children)
- If you’re over the age of 65
If the above signs aren’t evident they can be sent home IF they have appropriate support at home. They should rest, avoiding aspirin and NSAIDs for the first 72 hours, stay in easy reach of help and a phone, avoid stress, alcohol and driving for 3 weeks.If possible use a bit of to get stronger.
Symptoms should resolve within 3 weeks, if they are persisting or worsening they should get it checked by a medical professional.
A person that has sustained a head injury does not need to have lost consciousness to incur a concussion.
If the fallen rider is unconscious, the most important thing to consider is to maintain the person’s airways while waiting for the emergency services to arrive. It’s likely there could be damage to their neck too – so keep it still and supported. Monitor their breathing and apply CPR if necessary.