Nose Injury

What is a nose injury?

When a nose is hit, it often becomes bloody, bruised, and swollen. In most cases it is not broken. Even when it is broken, X-rays are usually not helpful.

If the nose looks crooked or different than it used to, you will need to see an ear-nose-throat surgeon at the time of the injury. Severe breaks of the nose are often fixed the same day in the operating room.

For questionable breaks of the nose, it works best to correct the break after the swelling is gone. That’s usually day 4 or 5. Then if the nose still looks abnormal, you will need to see the ENT surgeon within a day or so, because it needs to be re-set before the 10th day.

How can I take care of my child?

• Bruises or swelling. Apply ice to the area for 20 minutes. One hour later apply ice again for 20 minutes. Give acetaminophen (Tylenol) or ibuprofen (Advil) as necessary for pain. Do not give aspirin.
• Cuts or scrapes. Scrub the area with soap and water for 5 minutes. Then apply pressure for 10 minutes with a very clean cloth (or sterile gauze if you have it) to stop bleeding from the cut or scrape. If the scrape is large, apply an antibiotic ointment and cover the scrape with a Band-Aid for 1 day.
• Nosebleed. Have your child sit up, lean forward, and spit out any blood. Have a basin available so he can spit out any blood that drains into his throat. Have your child blow his nose once to remove any large clots. Then gently pinch the soft part of the nose between your thumb and forefinger for 10 minutes. Have your child breathe through his mouth. Don't release the pressure until 10 minutes are up. If bleeding continues, insert a gauze covered with petroleum jelly (Vaseline) or water-based jelly (K-Y) into the nostril. Squeeze again for 10 minutes. Leave the gauze in for another 10 minutes before you remove it. If bleeding continues, call your child's healthcare provider but continue the pressure in the meantime.

Call your child's doctor right away if:

• You are sure the nose is broken or crooked.
• The skin is split open and may need stitches.
• A nosebleed won't stop after 30 minutes of direct pressure.
• Fever occurs or your child can’t breathe through the nose.
• Your child can't breathe through the nose.

Call your child's doctor during office hours if:

• The shape of the nose has not returned to normal after 4 days.
• A yellow discharge, increasing soreness, fever, or other signs of infection occur.
• You have other concerns or questions.