Nose Injury  
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Does this describe your 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.

If not, see these topics

First Aid:

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.

 

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
  • Tip of nose is very tender to touch
  • 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.
    • 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 Medicine:
    • For pain relief, take acetaminophen.
    • Do not use aspirin for pain relief. Aspirin can interfere with normal blood clotting. Thus, it can increase the likelihood of nose bleeding.
    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.
    Extra Notes:
    • 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 acetaminophen overdose can hurt the liver.
    • CAUTION: Do not take acetaminophen if you have liver disease.
    • 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.

Disclaimer: This information is not intended 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.


Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 11/18/2011

Last Revised: 11/20/2011

Content Set: Adult HouseCalls Symptom Checker

Copyright 2000-2012. Self Care Decisions LLC; LMS, Inc.