Nose Injury

Symptoms

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 surgeons don't repair mild fractures 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 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 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.

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

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.
   • Even if the nose is broken, in most cases, the only treatment that is needed is cold packs and pain medications.
   • Surgery to fix the nose is only needed when the nose is very deformed. Swelling interferes with diagnosis and treatment. It is common practice is to delay fixing nose fractures until the swelling has decreased.
   • Looking at the nose after the swelling is gone (day 5 to 7) is the best way to tell if it is really fractured.
   • X-rays are often not helpful because 1.) minor fractures are treated the same as a bruise, and 2.) injuries to the cartilage do not show up on x-ray.
5. Pain Medicines:
   • For pain relief, take acetaminophen, ibuprofen or naproxen.
   • Acetaminophen (e.g., Tylenol):
     • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.
     • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.
     • The most you should take each day is 3,000 mg.

   • Ibuprofen (e.g., Motrin, Advil):

     • Take 400 mg by mouth every 6 hours

     • Another choice is to take or 600 mg by mouth every 8 hours.

     • Use the lowest amount that makes your pain feel better.

   • Naproxen (e.g., Aleve)

     • Take 250-500 mg by mouth every 12 hours.

     • Use the lowest amount that makes your pain feel better.

   • Extra Notes

     • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An overdose can hurt the liver.

     • Before taking any medicine, read all the instructions on the package.

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.