Children's Hospital Colorado

Nose Injury

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • Injuries to the inside or outside of the nose

Types of Nose Injuries

  • Nosebleed. Even minor nose injuries cause a nosebleed. The bleeding will stop with the correct technique. If the bleeding persists, the child needs to be seen.
  • Swollen Nose. Swelling and bruising of the outer nose without a fracture is common. It can be mistaken for a broken nose. The swelling will be gone in 4 or 5 days. Then the shape of the nose will look normal. But the bruising may take 2 weeks to clear.
  • Fracture of the Nose. Severe fractures of the nose (crooked nose) are usually reset the same day. This requires surgery in the operating room. Most surgeons don't repair mild fractures until 5 to 7 days after the injury. Caution: A nasal fracture must be re-set before 10 days.
  • Nasal Septal Hematoma (Serious). A blood clot of the central wall of the nose. It needs to be drained. If not, there's a risk of cartilage damage. That would lead to a deformed nose.

Call 911 Now

  • Major bleeding that can't be stopped
  • Passed out (fainted) or too weak to stand
  • You think your child has a life-threatening emergency

Go to ER Now

  • Bleeding that won't stop after 20 minutes of squeezing the nose correctly
  • Foreign body in the nose and can't get out
  • Large deep cut that will need many stitches

Call Doctor Now or Go to ER

  • Nosebleed that won't stop after 10 minutes of squeezing the nose correctly
  • Pointed object put in the nose and caused pain or bleeding
  • Skin is split open or gaping and may need stitches
  • Severe pain and not improved 2 hours after taking pain medicine
  • Deformed or crooked nose (not just swelling)
  • Breathing through the nose is completely blocked
  • Age under 1 year old
  • Nose becomes infected (fever, a yellow discharge, redness)
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Shape of the nose has not come back to normal after 4 days
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Dirty cut and no tetanus shot in over 5 years
  • Clean cut and no tetanus shot in over 10 years
  • You have other questions or concerns

Self Care at Home

  • Minor nose injury

Care Advice for Minor Nose Injury

  1. Nosebleed - How to Stop:
    • To stop a nosebleed, squeeze the soft parts of the lower nose together. Gently press them against the center wall.
    • Do this for 10 minutes to put pressure on the bleeding point.
    • Use the thumb and index finger in a pinching manner.
    • If the bleeding continues, move your point of pressure.
    • Have your child sit up and breathe through the mouth during this procedure.
  2. Skin Bleeding - How to Stop:
    • For any skin bleeding, put direct pressure on the wound.
    • Use a gauze pad or clean cloth.
    • Press for 10 minutes or until the bleeding has stopped.
  3. Clean the Cut:
    • After the skin bleeding has stopped, wash the area. Clean with soap and water for 5 minutes.
    • If a large area, use an antibiotic ointment (such as Polysporin.) No prescription is needed.
    • Then, cover with a bandage (such as Band-Aid) for 1 day.
  4. Cold Pack for Pain:
    • For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
    • Put it on the nose for 20 minutes.
    • Repeat in 1 hour, then as needed. Caution: Avoid frostbite.
  5. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  6. Concerns About Missing a Minor Nasal Fracture:
    • If a swollen nose is the only finding, usually it's not broken.
    • Even if it's broken, standard practice is to delay correction for a few days. This allows the swelling to go away. Reason: The swelling interferes with seeing the shape of the nose.
    • X-rays are often not helpful. Reason: Most of the nose is cartilage. Injuries to the cartilage do not show up on X-ray.
    • Looking at the nose after the swelling is gone is preferred. You can usually do this by day 4 or 5. This is the best way to tell if it is fractured. It will look different than it used to. Delayed correction also helps the surgeon better see what needs to be corrected.
    • Caution: If the nose is broken, a surgeon must re-set it. This should be done before the 10th day.
  7. What to Expect:
    • Nose pain and swelling usually peak on day 2.
    • They go away over 3 or 4 days.
  8. Call Your Doctor If:
    • Pain becomes severe
    • Nasal passage becomes blocked
    • Shape of the nose has not come back to normal after 4 days
    • Signs of infection occur (a yellow discharge, more tender to touch or fever)
    • You think your child needs to be seen
    • Your child becomes worse

Disclaimer

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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