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Head injury after fall on anticoagulation — DGM MCQ

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HardFallsHead injury after fall on anticoagulationDGM

A 78-year-old man has a fall with head impact while taking warfarin for atrial fibrillation. He is alert, GCS 15 and has a small scalp bruise. INR is 2.7, he lives alone and developed a headache 2 hours later. What is the most appropriate referral?

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Correct answer: E — Emergency department for urgent head injury assessment

Anticoagulation, head injury and new headache after a fall require urgent assessment for intracranial bleeding even if consciousness is preserved. A falls clinic may be useful later but does not address immediate head injury risk. Older anticoagulated patients can deteriorate after initially reassuring findings.

Reference: NICE NG232; NICE NG249