Head bump — what to know

First aid for a simple bump

• Apply a cold compress or ice pack (wrapped in cloth) for 15-20 minutes to reduce swelling.
• Rest and avoid strenuous activity for the day.
• Take acetaminophen (paracetamol) for pain if needed — avoid ibuprofen/aspirin initially if there's any chance of bleeding, since they can worsen bruising.
• A lump can take days to shrink; that alone isn't dangerous if the person is otherwise acting normally.

Watch for these red flags (adults and children) — seek emergency care (ER/911) if any occur, ideally within the first 24 hours but sometimes up to 72 hours after:

• Loss of consciousness, even briefly
• Repeated vomiting (more than once or twice)
• Confusion, slurred speech, or not recognizing people/places
• Worsening or severe headache
• Drowsiness that's hard to rouse from, or unusual sleepiness
• Seizure
• Weakness, numbness, or tingling in an arm or leg
• Unequal pupil size, double vision, or vision changes
• Balance problems, loss of coordination, or trouble walking
• Clear fluid or blood draining from the nose or ears
• Neck pain, or a visible skull deformity/depressed area
• Behavior that's just "not right" — irritability, sadness, being unusually withdrawn

Extra caution for infants

• A bulging soft spot (fontanelle)
• Refusing to feed or nurse
• Inconsolable crying
• Any bruising or swelling that seems excessive for the bump

Extra risk factors to consider

• Blood thinners (warfarin, DOACs, aspirin) or a bleeding disorder — lower threshold for urgent evaluation even with mild symptoms, since risk of intracranial bleeding is higher.
• High-force impact (fall from height, car accident, hitting concrete) even without immediate symptoms.
• Age over 65 or under 1 year — higher risk of complications.

Minor bump (no red flags — person alert, acting normally)

• Ice/cold compress: 15-20 minutes on, wrapped in a cloth, repeat every few hours for the first day to limit swelling.
• Rest: avoid sports, strenuous activity, or activities with fall risk for at least 24 hours.
• Pain relief: acetaminophen (paracetamol) is preferred initially. Avoid ibuprofen, aspirin, or other NSAIDs/blood thinners for the first 24 hours since they increase bleeding risk if there's any hidden bruising inside the skull.
• Observation: have someone check on the person periodically for the next 24 hours (wake a sleeping child/adult once or twice to confirm they rouse normally and are coherent).
• No screens/driving restriction needed unless dizziness, headache, or concentration problems appear — then rest from screens and exertion until symptoms clear.
• The lump itself may take several days to a couple of weeks to fully resolve; that alone doesn't need treatment beyond ice and time.

If it's a concussion (mild traumatic brain injury) — brief disorientation, headache, dizziness, but no severe red flags

• Physical and cognitive rest for 24-48 hours, then gradual return to normal activity as tolerated (this is the current standard — prolonged strict rest is no longer recommended).
• Avoid activities with re-injury risk (sports, cycling, etc.) until fully symptom-free and cleared by a clinician — return-to-play protocols exist for this reason.
• Acetaminophen for headache; stay hydrated; sleep as needed.
• Follow up with a doctor within 1-2 days if symptoms persist, even without severe features.

If any red-flag signs appear (from what I outlined last time — loss of consciousness, repeated vomiting, confusion, worsening headache, weakness/numbness, seizure, unequal pupils, fluid from ears/nose, trouble waking)

• This needs emergency evaluation, not home treatment. The ER will typically do a neurological exam and, if indicated, a CT scan to check for intracranial bleeding (epidural/subdural hematoma) or skull fracture.
• Treatment then depends on findings: observation, and in more serious cases neurosurgical intervention (e.g., hematoma evacuation) if there's significant bleeding with mass effect.
• Anyone on blood thinners (warfarin, DOACs, aspirin/clopidogrel) with a head injury should generally be evaluated urgently regardless of symptom severity, since bleeding risk is higher and can be delayed in onset.