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She hit her head and she don't want to go to er.

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You need to call the paramedics and have her transferred. She is not making logical decisions...she has a head injury. This can be very serious in people of all ages but particularly a senior. She could have a bleed on her brain (hemorrhage) which could clot and cause a stroke. She could have broken bones. Do the right thing for her and call someone now.

Angel
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I am no kin and her kids dontvlive on same town and she refuses to go to ER so dont know what to do
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You can still call the paramedics, explain what happened, and ask for a wellness check for her. They can then decide what type of care is needed. A head injury means that she may not be making logical well thought out choices, her choice not to go to the ER in such a serious situation is an example of that deficiency. Still make the call...what could it hurt? It could possibly save her life.

Angel
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Deb, who is your friend's first line of contact if there is anything wrong? Visit your friend and ask her, tell her you need that person's name and number to keep on hand in case there is an emergency. Then you go home, call that person and explain what happened.

Head trauma can lead to other serious medical issues.... I know, I saw first hand what a fall with head trauma did to my mother.
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She knows she is hurt and is afraid that when she goes for treatment she will never be allowed to come back home. Try to help her see that it may be something that can be treated easily, but if she neglects to get care her worst fears just may come true.
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Call the nearest relative and advise them of what happened. If they are unable to get there soon, tell them you will need to call 911 to have her evaluated because she may have a head injury. When 911 comes they will determine the course of action. Dont leave yourself in what could end up being a dangerous situation and a possible lawsuit.
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Megan, how could a lawsuit arise from the OP's failure to act? She's not a mandated reporter, she has no obligation to act, she's tried to but her friend has refused. I've actually read of a suit against a good Samaritan who did in fact attempt to intervene against the injured person's wishes.
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You might also research to determine if there are any home care physicians in your area. I doubt they could do x-rays, but by palpating they might be able to determine if there are any internal injuries
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In this day and world, you never know what people will do. I would call 911 and play safe. It's her call....just my opinion...
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