Should Your Child See a Doctor?

Nose Injury

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
  • 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 If…

 
  • Your child has major bleeding that can't be stopped
  • Your child has fainted or is 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 10 minutes of squeezing the nostrils closed and applied twice
  • Pointed object inserted into nose and causes pain or bleeding
  • Skin is split open or gaping and may need stitches
  • Severe pain
  • Very deformed 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 under 1 year old
  • Nose looks infected (fever, a yellow discharge, redness)
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) 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
  • No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
 

Parent Care at Home If

  • Minor nose injury and you don't think your child needs to be seen
 

Home Care Advice for Minor Nose Injury

  1. Nosebleed: 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.
  2. Skin 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 such as Polysporin (no prescription needed). Then, cover with a Band-Aid for 1 day.
  4. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for pain relief.
  5. Concerns About Missing a Minor Nasal Fracture:
    • A swollen nose usually is not broken
    • If it is broken, standard practice is to delay correction until the swelling is gone
    • The swelling interferes with diagnosis and treatment
    • 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 may need to be corrected.
    • In summary, it's safe to delay the treatment of a mild nasal fracture.
     
  6. Call Your Doctor If:
    • Pain becomes severe
    • Nasal passage becomes blocked
    • 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
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. Ginsberg CM. Nasal septal hematoma. Pediatr Rev. 1998; 19(4):142-143.
  2. Lopez M, Liu J, Harley B, et.al. Septal hematoma and abscess after nasal trauma. Clin Pediatr. 2000;39:609-610.
  3. Savage R, Valvich C. Hematoma of the nasal septum. Pediatr Rev. 2006;27(12):478-479.

Disclaimer

This information is not intended 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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/18/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.