<s>[INST] today my son flew 4 ft in air and landed on his shoulder while sledding.  We went to er and they took x-rays and gave him 409mg ibuprofen.  Said his shoulder was just bruised.  He has been ok rest of day but is now throwing up...should I be concerned of a concussion and should I take him back to er to be checked? [/INST] Hi, Vomiting is common symptom after mild trauma due to vertigo (especially if head is involved) in your sons' case as per your note he landed on his shoulder, if you didn't noticed any symptoms of head involvement It can resolve itself within a couple of days. But if you are suspicious of head trauma only a CT scan can confirm concussion or serious head injury, if this is the case appropriate physician must be consulted (Neurologist). I hope this answers your question. Chat Doctor.  </s>