Any of the following is acted on immediately. EMS is activated first for life- or vision-threatening findings; provider notification and orders follow.
Red flags — act immediately
Head strike on an anticoagulant with any new headache, vomiting, confusion, drowsiness, unequal pupils, or focal deficit → activate EMS — time-critical for a delayed intracranial bleed (cross-reference Anticoagulation and Neurological).
Sudden “worst-ever” or thunderclap headache → activate EMS.
New headache with fever and neck stiffness → possible meningitis — activate EMS / urgent evaluation.
Temporal-artery tenderness with jaw claudication and visual change in an older adult → possible giant-cell arteritis; notify urgently (vision-threatening).
A skull step-off, depression, or boggy swelling after trauma → possible fracture; activate EMS.
Shunt-tract swelling or signs of malfunction with headache, vomiting, or mentation change → notify urgently for possible shunt failure.
