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Head injury on anticoagulants — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementHead injury on anticoagulantsDipIMC

A 58-year-old anticoagulated man falls down steps and has a brief loss of consciousness. He is alert on your arrival, has a scalp haematoma and vomits once while being assessed. What is the most appropriate transport decision?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Transport to an emergency department capable of urgent head injury assessment

Head injury in an anticoagulated patient with vomiting and transient loss of consciousness requires emergency department assessment and likely imaging according to head injury pathways. Normal current alertness does not make the risk negligible. Minor injury services may not provide timely CT or reversal pathways. The pearl is that anticoagulation lowers the threshold for hospital assessment after head trauma.

Reference: NICE Head Injury NG232; JRCALC Guidelines 2025