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 5 to 7 days after the injury.
WHEN TO CALL YOUR DOCTOR FOR NOSE INJURY
Call 911 Now (your child may need an ambulance)If
Major bleeding that can't be stopped.
Fainted or too weak to stand.
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 squeezing 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 not due to crying.
Breathing through the nose is blocked on one side or both sides.
Age less than 1 year old.
Call Your Doctor Within 24 Hours (between 9am and 4pm) 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 MILD INJURY
1. Pain Medicine: Give acetaminophen (e.g. Tylenol) 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. It will look crooked or different than it used to. 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" symptoms.
Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.
