Hit back of head on wooden ledge; on blood thinner. (bleeding, doctor)
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Hit back of head on wooden ledge; on blood thinner. Should I go to the ER?
I am on Warfarin due to having a St Jude Mechanical Heart Valve.
I didn’t hit my head especially hard and there is no bump. With COVID and everything, no one wants to go to the ER if at all possible. It happened 10 hours ago now as I write this.
Hit back of head on wooden ledge; on blood thinner. Should I go to the ER?
I am on Warfarin due to having a St Jude Mechanical Heart Valve.
I didn’t hit my head especially hard and there is no bump. With COVID and everything, no one wants to go to the ER if at all possible. It happened 10 hours ago now as I write this.
Because of the Warfarin, go to ER
Last thing you want to deal with is a subdural hematoma
I think anyone who is on Warfarin should understand the responsibility that they carry while on the drug. The major concern is intracerebral hemorrhage (ICH). I think you knew that which is why you brought up the head trauma and characterized it as minor. The decision to seek help should be immediate and not delayed. The concern is a very high death rate among those on Warfarin with ICH compared to other areas of blood loss like GI tract etc. The incidence is higher in those with high INR's and increased age.
The symptoms of ICH are neurological but as stated time is essential in the proper treatment. You decided that it was minor but you should at the very least have called your primary doctor or presented yourself to a doctor in the ER for evaluation and monitoring. That is what they are there for.
I can't tell you how many times or how common that is for an elderly person falling off a ladder while on Warfarin. Old people fall all of the time and old people are on Warfarin a lot of the time.
I think anyone who is on Warfarin should understand the responsibility that they carry while on the drug. The major concern is intracerebral hemorrhage (ICH). I think you knew that which is why you brought up the head trauma and characterized it as minor. The decision to seek help should be immediate and not delayed. The concern is a very high death rate among those on Warfarin with ICH compared to other areas of blood loss like GI tract etc. The incidence is higher in those with high INR's and increased age.
The symptoms of ICH are neurological but as stated time is essential in the proper treatment. You decided that it was minor but you should at the very least have called your primary doctor or presented yourself to a doctor in the ER for evaluation and monitoring. That is what they are there for.
I can't tell you how many times or how common that is for an elderly person falling off a ladder while on Warfarin. Old people fall all of the time and old people are on Warfarin a lot of the time.
I did go to Urgent Care hours later but the doctor there said I should I come right away even though this time they did not find anything. Since you seem to know more about this stuff, what can they even do for an ICH? Anything else on the subject you are able to share?
I did go to Urgent Care hours later but the doctor there said I should I come right away even though this time they did not find anything. Since you seem to know more about this stuff, what can they even do for an ICH? Anything else on the subject you are able to share?
The doctor was right in what he did and said. I didn't know the urgent care had access to CT's. ICH and patients on anticoagulants have about a 73% mortality rate in contrast to a GI bleed of about 3%. It is important to maintain your INR in the therapeutic range because one doesn't need trauma or anything to initiate a ICH when the INR is out of range. There has been much controversy with the PT over the years which is why they came up with the universal International Normalized Ratio (INR). They did it to prevent over anticoagulation due to the variability of the tissue being used in PT testing.
It is imperative that they reverse the anticoagulation all the way or at least to reasonable range with special blood products prothrombin complexes and or plasma and platelets to make sure one stops the bleeding. The brain is incased in a closed cavity skull and there is no room for extra fluid or blood and a person will decompensated neurologically and pass. It is much better if it is a small controlled bleed that is manageable.
When it comes to hemorrhagic stroke or thrombotic stroke it is imperative that you present as soon as possible to a treating center. There are two differnt levels of stroke centers in the US. One is more extensive than the other but quite a few if not most places do not have any. A CT must be completed within an hour or so and the lab work within 45 minutes inclusive of a PT and PTT etc. Outcome studies have shown a difference on where patients are taken. Suffice it to say that large hospitals would be better abled to handle such patients and if there is a trauma system then they should know where to go.
Good luck to you and take care by watching your INR.
With COVID and everything, no one wants to go to the ER if at all possible.
OK, we need to address this.
ERs screen people -- usually at the entrance -- for COVID symptoms. The COVID patients are taken to another area and isolated.
It is safe to go to the ER for examination and treatment. I've visited an ER twice this year, no problems either time.
Hope you feel better soon.
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