Should Seniors Seek Immediate Medical Attention After a Fall?

An elderly person nearly 80 years old fell and hit their head?

Hello Dr.
Jiang, there is an elderly person who fell and hit his head in the bathroom before taking a shower.
We discovered him about an hour later, and he had already bathed and changed his clothes, and he was able to describe the incident.
The elderly man said that when he hit his head, he couldn't stand up at first, and he felt pain at the impact site, but after a while, he was able to support himself on the sink and managed to stand up, bathe, and change clothes.
When we found him an hour later, there was redness and swelling at the site of the impact, but he said he did not feel dizzy and had no other discomfort.
Should we take him to the hospital immediately or observe him until morning before seeking medical attention? If immediate medical attention is necessary, should we go to the emergency room or are there other options for night clinics? Thank you for your assistance.

Wei, 20~29 year old female. Ask Date: 2020/04/19

Dr. Jiang Junyi reply Neurology

Hello, based on your description, generally speaking, if there is no loss of consciousness, use of anticoagulants, or obvious localized hematomas, head trauma is mostly mild.
However, the following conditions should prompt consideration of delayed bleeding, and you should seek treatment in the emergency room: (1) Deterioration of vision, seeing double (diplopia), or unequal pupil size.
(2) Clear fluid or blood leaking from the ears or nose.
(3) Confusion or abnormal behavior.
(4) Numbness or inability to move limbs.
(5) Localized involuntary movements or seizures.
If the initial CT scan of the brain is normal, it is still important to monitor elderly patients closely, as chronic subdural hematoma may occur.
The observation period should be extended to one month.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2020/04/19

More Info

When it comes to seniors who have experienced a fall, especially one that involves a head injury, it is crucial to err on the side of caution and seek immediate medical attention. Even if the individual appears stable and is able to describe the incident, there are several factors to consider that could indicate a need for urgent care.

Firstly, the elderly population is at a higher risk for complications following a fall, particularly when it involves a head injury. The risk of intracranial hemorrhage (bleeding within the skull) is significant, even if the person does not exhibit immediate symptoms such as dizziness, confusion, or loss of consciousness. Symptoms of a serious head injury can sometimes take hours or even days to manifest, which is why close monitoring is essential.

In the scenario you described, the elderly individual experienced a fall and subsequently showed signs of a head injury, such as redness and swelling at the impact site. While he reported no dizziness or other discomfort, the absence of these symptoms does not guarantee that there are no underlying issues. The fact that he was unable to stand immediately after the fall raises concerns about potential concussion or other brain injuries.
Given these considerations, it is advisable to take the following steps:
1. Immediate Assessment: Even if the individual seems stable, a medical professional should evaluate him as soon as possible. This can include a physical examination and potentially imaging studies like a CT scan to rule out any serious injuries.

2. Emergency Room Visit: If you decide to seek medical attention, it is best to go to the emergency room (ER). The ER is equipped to handle acute situations and can provide the necessary diagnostic tests and treatments. If there are any signs of confusion, severe headache, or any other concerning symptoms, it is critical to go to the ER immediately.

3. Monitoring: If you choose to observe the individual overnight, ensure that he is monitored closely for any changes in his condition. Look for signs such as worsening headache, confusion, difficulty waking up, or any new symptoms. If any of these occur, seek emergency care right away.

4. Follow-Up Care: Regardless of whether you go to the ER or decide to wait, it is important to arrange for follow-up care with a primary care physician. They can assess the individual’s recovery and determine if any further evaluation or treatment is necessary.

In summary, while the elderly individual in your scenario may seem stable, the potential risks associated with head injuries in seniors warrant immediate medical evaluation. It is always better to be cautious and ensure that any possible complications are addressed promptly.

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