My 76-year-old father, who takes the blo
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My 76-year-old father, who takes the blood thinner Eliquis daily for atrial fibrillation, tripped on a rug 45 minutes ago and bumped his forehead against the wooden coffee table.
There is a slight red mark on his forehead, no open bleeding now. However, he seems dazed, complains of a mild headache, and is insisting on lying down on the sofa to take a nap and "sleep it off".
Should I let him sleep for a couple of hours to rest, or take him directly to the nearest emergency department right now? How urgent is this given his blood thinner medication?
Answer
Take him to the emergency department now — do not let him lie down to sleep.
The combination is what matters: a knock to the head in a 76-year-old who takes a daily blood thinner (Eliquis / apixaban), with him already seeming dazed and having a headache. Even when the outside wound looks like nothing, bleeding inside the skull can build quietly for hours or even days under a blood thinner, and "sleeping it off" is exactly how a slow bleed is missed until it is too late. The team that needs to see him has the scanner. Please go now, and call your local emergency number if driving yourself would take longer than the ambulance.
**In the next minutes**
- Keep him awake and talking on the way. The changes that mean you do not wait for the ED at all — call the ambulance instead — are: new drowsiness that is hard to rouse, confusion worse than now, slurred speech, weakness or numbness on one side, repeated vomiting, a seizure, fluid or blood from the ear or nose, or one pupil looking different from the other.
- Do not give food or drink yet — if he needs a scan or an operation, an empty stomach matters.
- Do not give aspirin, ibuprofen, or any new painkiller for the headache. Masking the pain does not make a bleed smaller, and some painkillers make bleeding worse.
- Note for the team: the fall was about 45 minutes ago, he hit his forehead on a wooden coffee table, he is on Eliquis, he seems dazed, and he has a mild headache.
**Take with you**
- His Eliquis box, or a clear photo of the label — and tell triage out loud that he takes a blood thinner called apixaban and the dose he had today.
- The full list of his medicines in their boxes, including anything for the heart, blood pressure, diabetes, or any other blood thinner.
- His glasses and hearing aids if he uses them.
- His age and what he is normally like, so "dazed" can be judged against his own baseline rather than a stranger's.
**Do not**
- Do not let him "sleep it off" on the sofa. A bleed can worsen while he sleeps, and you would not see it until he stopped waking up.
- Do not skip the trip because the red mark is small. With blood thinners, the outside can look trivial while the inside is the problem.
- Do not stop, restart, or change his Eliquis on your own. That decision belongs to the team that has scanned him, because both stopping and continuing carry risk here.
**What I cannot do from here**
- I cannot diagnose what is happening inside his skull — only a scan and the team looking at him can.
- I cannot tell you whether to stop, hold, or change his Eliquis. That is a decision for the team that has the scan, his full list, and his bleeding history.
- I cannot name a specific door without knowing where you are.
**Which country or city are you in right now?** Tell me the city and country and I will point you to the nearest emergency department and the right local number to call from the car.