Nose Injury

Adult HouseCalls Online

DEFINITION

• Injuries to the inside or outside of the nose

Types of Nose Injuries

• Bloody nose without a fracture
• Swelling and bruising of the nose without a fracture
• Nasal Septal Hematoma
• Fracture of the nose: Severe fractures of the nose (e.g. crooked nose) are usually reset the same day in the operating room. Most mild fractures aren't repaired until day 5 to 7 post-injury. 

See More Appropriate Topic (instead of this one) If

• HEAD INJURY is the main concern

FIRST AID Advice

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Nosebleed:  

• Placing your thumb and index finger over each side of the soft lower portion of the nose, firmly pinch the nostrils together. Pinch the nostils nostrils together for 10-15 minutes.
• Lean slightly forward; this keeps the blood from trickling down the back of your throat.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

---

WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Knocked out (unconscious)
• Major bleeding that can't be stopped
• Fainted or too weak to stand following major blood loss

Call Your Doctor Now (night or day) If

• You think you have a serious injury
• Nosebleed won't stop after 20 minutes of pinching the nostrils closed
• Skin is split open or gaping and may need stitches
• Very deformed or crooked nose
• Watery fluid dripping from the nose or ear
• Breathing through the nose is blocked on one or both sides
• Black and blue skin around both eyes

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If:

• You think you need to be seen
• Shape of the nose has not returned to normal after 5 days
• No tetanus booster in more than 10 years (5 years for dirty cuts and scrapes)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Self Care at Home If

• Minor nose injury and you don't think you need to be seen

---

HOME CARE ADVICE FOR MINOR INJURY OF THE NOSE

1. Treatment of Superficial Cuts and Scrapes (abrasions):
   • Apply direct pressure with a sterile gauze or clean cloth for 10 minutes to stop any bleeding.
   • Wash the wound with soap and water for 5 minutes.
   • Apply an antibiotic ointment. Cover large scrapes with a Band-Aid or gauze dressing. Change daily.
2. Treatment of Swelling or Bruise with Intact Skin:
   • Apply a cold pack or an ice pack (wrapped in a moist towel) to the area for 20 minutes each hour for 4 consecutive hours.
   • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
3. Nosebleed:
   • Place your thumb and index finger over each side of the soft lower portion of the nose.
   • Firmly pinch the nostrils together for 10-15 minutes.
4. Concerns About a Broken (fractured) Nose:
   • Not all swollen noses have a fracture
   • If it is broken, standard practice is to delay correction until the swelling is gone. The swelling interferes with diagnosis and treatment.
   • X-ray films are often not helpful because injuries to the cartilage do not show up. (Most of the nose is cartilage.)
   • Looking at the nose after the swelling is gone (day 5 to 7) is the best way to tell if it is really fractured. Delayed surgery also helps the surgeon better see what needs to be fixed.
5. Pain Medication: For pain relief, take acetaminophen (e.g. Tylenol) every 4-6 hours (adults 650 mg). Do not use aspirin for pain relief as it interferes with your normal clotting and thus can increase the likelihood of nose bleeding.
6. Call Your Doctor If:
   • Pain becomes severe
   • Shape of the nose has not returned to normal after 5 days
   • Signs of infection occur (a yellow discharge, increasing tenderness or fever)
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.