Minor head injury triage
Primary care and urgent-care triage framework for minor head injury with immediate escalation thresholds.
Last reviewed February 7, 2026
Red flags
- Deteriorating consciousness, repeated vomiting, focal neurologic deficit, or seizure.
- Signs of skull fracture or significant cervical injury.
- Persistent severe headache with worsening neurologic symptoms.
Assessment priorities
- Confirm mechanism, loss of consciousness, amnesia, and symptom progression.
- Screen for anticoagulation use and high-risk bleeding context.
- Assess neurologic status and cervical-spine risk indicators.
Initial management
- Assess urgent imaging/ED disposition with an age-appropriate pathway; adult CT rules must not be used outside their inclusion criteria or to clear anticoagulated patients.
- If home observation is safe, recommend relative rest for 24–48 hours, then graded cognitive/physical activity as tolerated. Avoid prolonged strict rest and activities risking another injury.
- Give explicit warning signs requiring immediate emergency reassessment.
Follow-up and escalation
- Arrange short-interval reassessment for persistent post-injury symptoms.
- Escalate immediately for any neurologic deterioration.
- Coordinate concussion-focused follow-up for prolonged recovery.
References
- Living Concussion Guidelines Diagnosis (opens in a new tab)
- Living Concussion Guidelines Initial management (opens in a new tab)
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