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What to do if…
you hit your head and later develop worsening headache, nausea, or unusual sleepiness

Short answer

Get urgent assessment now. If you’re very drowsy/hard to wake, vomiting repeatedly, having a seizure, or getting confused, call 999; otherwise go to A&E now (or call NHS 111 for urgent direction if you can’t get there safely).

Do not do these things

  • Do not “sleep it off” alone if you feel unusually sleepy, your symptoms are worsening, or you’re hard to wake.
  • Do not drive yourself to get help if you feel sleepy, dizzy, confused, or your symptoms are worsening.
  • Do not drink alcohol or use recreational drugs after a head injury.
  • Do not take sedating medicines (sleeping tablets, strong sedating antihistamines, sedative painkillers) unless a clinician tells you to.
  • Do not take aspirin for pain after a head injury unless a clinician has specifically told you to. If you’re prescribed aspirin or blood thinners, do not stop them without medical advice.
  • Do not dismiss worsening symptoms because the hit “wasn’t that bad”.

What to do now

  1. Call 999 now if any danger sign applies. This includes: the person was knocked out and has not woken up; they’re very drowsy, difficult to keep awake, or struggling to keep their eyes open; a seizure/fitting; repeated vomiting; a worsening or severe headache; increasing confusion, slurred speech, or unusual behaviour; weakness or numbness; problems walking, balance, understanding, speaking, or writing; problems with vision or hearing; clear fluid from the nose or ears; bleeding from the ears or bruising behind the ears.
    • If the injured person is a child: call 999 if they fell from a height (more than about 1 metre or 5 stairs) and you’re now seeing worsening symptoms.
  2. If symptoms are worsening but none of the above apply, go to A&E now. If you cannot get there safely, call NHS 111 and say: “head injury with worsening headache/nausea/unusual sleepiness,” and follow their instructions.
  3. Do not stay alone. Ask a responsible adult to stay with you (or the injured person), especially through the next sleep/overnight period, and to seek urgent help if symptoms worsen.
  4. Treat it as higher risk and choose A&E promptly if any apply: you take blood thinners (or have a bleeding/clotting disorder); you’re an older adult; the impact was high force (e.g., road traffic collision, significant fall); you had any loss of consciousness or a memory gap.
  5. Reduce strain while you’re getting help. Rest quietly; keep screens/bright light low if they worsen symptoms; sip water. For pain, paracetamol is usually the safest first choice unless a clinician has told you otherwise.
  6. Have key details ready for 111/A&E. When and how it happened, what has worsened (headache, nausea/vomiting, sleepiness), any blackout/memory gap, medicines (especially blood thinners), allergies, and major conditions.

What can wait

  • You do not need to decide whether this is “concussion” or something else right now — the priority is assessment because symptoms are worsening.
  • You do not need to write a detailed symptom diary; just keep the injury time and the main changes clear.
  • You do not need to decide about work, school, sport, or driving today. That comes after you’ve been checked.

Important reassurance

It’s common to feel shaken and unsure after a head injury — especially when you start feeling worse later. Getting checked promptly when symptoms worsen is a protective step that helps rule out serious problems.

Scope note

These are first steps only to reduce immediate risk and get you to the right level of care. Follow-up recovery advice depends on what clinicians find.

Important note

This is general information, not a diagnosis. If you’re unsure whether someone is “more sleepy than usual,” or the injured person is a child, pregnant, or medically complex, choose urgent assessment rather than waiting.

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