<s>[INST] My wife took a fall and hit her head.  She has a pretty painful knot on the back of her head.  She is in quite a bit of pain and did feel a little nausea & dizzy which has passed.  We are icing her head now.  Do we need to go to the ER or wait and see if the knot goes down? [/INST] Hi there,If your wife lost consciousness, is over 65, or on blood thinning medication such as Coumadin (warfarin), plavix, Pradaxa, or lovenox, or has a history of bleeding disorders, then I recommend you take her to the ER for a head CT. if your wife did not lose conciousness and is not on a blood thinner, and doesn't have any history of bleeding disorders, then it is reasonable to continue to ice the affected area. I recommend 15 minutes of ice on, 15 minutes off and repeat as many times as possible. I hope I have answered your question. Feel free to contact me if you have any further questions. </s>