Nose Trauma

Injury Definition
Injuries to the inside or outside of the nose

Types of nose injuries include the following:

  • Bloody nose without a fracture.
  • Swelling and bruising of the nose without a fracture.
  • Blood clot of the central wall of the nose with risk of cartilage damage and deformed nose.
  • Fracture of the nose. Severe fractures of the nose (e.g. crooked nose) are usually reset the same day in the operating room. Most surgeons don’t repair mild fractures until day 5 to 7 post-injury.

Call 911 Now (your child may need an ambulance) If:

  • 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 your child has a serious injury
  • Nosebleed that won’t stop after 20 minutes of pinching the nostrils closed
  • Skin is split open or gaping and may need stitches
  • Definitely broken or crooked nose
  • Clear fluid is dripping from the nose and is not due to crying
  • Breathing through the nose is blocked on one side or both sides
  • Age < 1 year old

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

  • You think your child needs to be seen
  • Shape of the nose has not returned to normal after 5 days

Call Your Doctor During Weekday Office Hours If:

  • You have other questions or concerns

Parent Care at Home If:

  • Mild nose injury and you don’t think your child needs to be seen

Home Care Advice for Swollen/Bruised Nose:

  1. Pain Medicine: Give acetaminophen or ibuprofen as needed for pain relief.
  2. Bleeding: For superficial cuts or scrapes, apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding.
  3. Cleansing: Then wash the area with soap and water for 5 minutes. If a large area, apply an antibiotic ointment and cover with a Band-Aid for 1 day.
  4. Nosebleeds: To stop a nose bleed, squeeze the soft parts of the nose against the center wall for 10 minutes to apply pressure to the bleeding point.
  5. Concerns About Missing a Mild Nasal Fracture:
    • It’s hard to diagnose a broken nose because of nasal swelling (most swollen noses have no fracture).
    • X-rays 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 correction also helps the surgeon better see what he is changing. In addition, it’s safe to delay the treatment of a mild nasal fracture.
  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)
    • Your child becomes worse or develops any of the “Call Your Doctor Now” symptoms