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Head injury: assessment and early management

A Canadian clinical summary of head injury: assessment and early management, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Ontario is used as an explicit Canadian implementation example, not as a national rule. Verify the equivalent pathway, formulary and escalation route in the patient鈥檚 province or territory.

Ontario source: bounded use

This Ontario living guideline covers concussion and mild traumatic brain injury in adults. It does not establish paediatric head-injury imaging or safeguarding pathways, which require the applicable paediatric and provincial source.
sources for this section:Ontario concussion guideline

Source-attributed clinical priorities

  • Stabilize airway and cervical spine concerns, assess Glasgow Coma Scale and identify anticoagulation or bleeding risk.
  • Use the applicable Canadian emergency imaging rule only in its validated population and arrange observation when needed.
  • Provide explicit return precautions and graded return-to-activity advice after discharge.
  • Document the exact mechanism and time, loss of consciousness, amnesia, vomiting and neurologic change.
sources for this section:Ontario concussion guideline

Practical assessment and management workflow

1
Stabilize cervical spine and airway threats and record serial Glasgow Coma Scale and pupil findings.
2
Identify anticoagulant or antiplatelet use, bleeding disorder, intoxication, seizure and safeguarding concerns.
3
Apply a validated Canadian CT rule only when inclusion and exclusion criteria are met.
4
Before discharge, confirm supervision, written return precautions and a staged return to cognitive and physical activity.
sources for this section:Ontario concussion guideline

Safety, red flags and urgent escalation

  • Deteriorating consciousness, focal deficit, repeated vomiting, seizure or signs of skull fracture needs emergency imaging and consultation.
  • Do not discharge a patient whose assessment is unreliable without safe observation.
  • Advise immediate return for worsening headache, confusion, weakness, fluid from ear or nose, or new vomiting.
sources for this section:Ontario concussion guideline

Confirm the local pathway before acting

Ontario is used as an explicit Canadian implementation example, not as a national rule. Verify the equivalent pathway, formulary and escalation route in the patient鈥檚 province or territory.
sources for this section:Ontario concussion guideline

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:Ontario concussion guideline

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Ontario Neurotrauma FoundationLiving Concussion Guidelines: Diagnosis and Initial ManagementLiving guideline; diagnosis section updated through 2024 路 accessed 2026-08-20
    view source
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