A knock to the head is one of those injuries where the family group chat lights up: "Should we go to hospital?" The honest answer depends less on how the bump looked and more on what happens in the four to six hours afterwards. Here is the clean framework.
Call 000 immediately
Emergency signs — no delay, no debate
- Loss of consciousness, even briefly
- Seizure or fit after the injury
- Vomiting more than once after the head injury
- Clear watery fluid coming from the nose or ears
- Unequal pupils or one pupil not reacting to light
- Severe or worsening headache, particularly one described as the worst ever
- Difficulty waking, drowsiness, or unresponsive
- Weakness or numbness in an arm or leg, or slurred speech
- Any head injury in a baby under 12 months, or in someone on blood-thinning medication
Come to urgent care tonight
Walk in to us (or phone first on 0403 025 359) if you have a head injury without the red flags above but you have any of these:
- Persistent nausea but no vomiting
- Headache that isn't easing with paracetamol
- Feeling foggy, off-balance, or slow to think — classic concussion symptoms
- Sensitivity to light or noise that started after the injury
- A visible scalp cut that may need cleaning, closure or a tetanus check
- Difficulty concentrating or feeling emotional in an unusual way after the injury
We can assess for concussion using a structured clinical assessment (the SCAT-based approach), document the injury for insurance or return-to-sport purposes, close scalp lacerations, and give clear return-to-activity advice.
Rest and observe at home
For a simple bump — no red flags, no persistent symptoms — home observation is fine. The rules are straightforward:
- Don't leave the injured person alone for the first 24 hours
- Wake them briefly every 2 to 3 hours in the first night to check they can be roused and are behaving normally
- Simple analgesia (paracetamol) is fine; avoid ibuprofen in the first 24 hours because of the bleeding-risk-if-there-is-an-undetected-bleed concern
- No alcohol
- No driving until symptom-free for 24 hours
- Return the following morning if any red-flag symptoms develop
Concussion — what it actually is
Concussion is a functional injury to the brain caused by biomechanical forces. There is no structural damage on CT scan (that's why a normal CT doesn't rule out concussion). The clinical picture includes:
- A brief alteration in awareness (dazed, "seeing stars," slow to respond) at the time of injury
- Headache, nausea, dizziness, sensitivity to light and noise in the hours to days afterwards
- Difficulty concentrating and short-term memory difficulty for up to 10–14 days
- Emotional lability — feeling more anxious, low, or irritable than usual
Recovery for most adults is 7 to 14 days. Recovery for children and adolescents can be longer — up to 4 weeks. Symptoms lasting beyond 4 weeks warrant referral to a specialist concussion clinic.
Return to play, return to work
Australian sporting bodies (AFL, cricket, rugby, netball) have adopted a stepwise return-to-play protocol. The essential rule: no same-day return to contact sport. A minimum 24 hours symptom-free, then a graduated return over 6 to 7 days, with each stage lasting at least 24 hours before progressing. Any return of symptoms drops back a stage.
Return to work is similar — start with light cognitive load, avoid screen-heavy work for the first few days, and increase gradually.
If in doubt, phone us
Head injuries are one of the areas where telephone triage genuinely helps. A two-minute chat with our clinician often clarifies whether tonight, tomorrow, or ED is the right move. The call is free.