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Head injury on DOAC — DGM MCQ

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HardFallsHead injury on DOACDGM

An 82-year-old man attends after a fall with head strike on a pavement. He takes apixaban and has a small scalp haematoma. He is alert with no focal signs but cannot recall the impact. Current medicines include apixaban and atorvastatin. What is the most appropriate referral?

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Correct answer: B — Emergency department assessment for head injury pathway

Head injury in an anticoagulated older person warrants urgent assessment under a head injury pathway even if initial neurological examination is reassuring. Physiotherapy, podiatry, memory and audiology referral do not address the immediate intracranial bleeding risk. Anticoagulants lower the threshold for urgent assessment after head injury.

Reference: NICE head injury guidance; NICE NG249