What to do if…
you hit your head and now have a worsening headache, nausea, or unusual sleepiness

What to do now

1. Call 999 now if any emergency danger sign applies. This includes: the person was knocked out and has not woken up; they cannot stay awake or keep their eyes open; they have a seizure or fit; they have weakness or numbness in part of the body; they have problems walking, balancing, understanding, speaking, writing, seeing, or hearing; clear fluid is coming from the nose or ears; there is bleeding from the ears or bruising behind the ears; there is a black eye without direct injury to the eye; there is a dent to the head or a head wound with something inside it; the head was hit at speed, such as in a car crash, bicycle collision, being hit by a vehicle, or a diving accident; or they fell from more than 1 metre or more than 5 stairs.
2. Go to A&E now if symptoms are worsening but none of the 999 signs apply. This includes a worsening or persistent headache, vomiting after the injury, unusual sleepiness, confusion that is new for the person, memory problems, behaviour that is not normal for the person, any loss of consciousness that has now passed, or a head wound, swelling, or bruise that concerns you.
3. If worsening nausea is the only symptom and none of the A&E or 999 signs apply, contact NHS 111 now for urgent direction. Say: “head injury with worsening nausea,” and tell them when the injury happened. Go to A&E if 111 tells you to, if you cannot get advice promptly, or if any symptom worsens.
4. Do not stay alone. Ask a responsible adult to stay with you or the injured person, especially during the first 24 hours after the injury, and to call 999 or get you to A&E if symptoms worsen.
5. Treat it as higher risk and choose A&E promptly if any apply: you take anticoagulants, antiplatelet medicine, or aspirin; you have a bleeding or clotting disorder; you are age 65 or over; you had brain surgery in the past; the impact was high force; you had any loss of consciousness; or there is a memory gap from before or after the injury.
6. Reduce strain while you are getting help. Rest quietly, avoid alcohol and drugs, keep screens and bright light low if they worsen symptoms, and sip water only if you are fully awake and not repeatedly vomiting. For pain, paracetamol is the usual first choice unless you have been told not to take it.
7. Have key details ready for 999, 111, or A&E. Note when and how it happened, what has worsened, whether there was any blackout or memory gap, any vomiting, current medicines, allergies, major medical conditions, and whether the injured person is a child, pregnant, or medically complex.