NOSE INJURY |
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General Information
DEFINITION--Nose injuries include:
Fractures of the nasal bones.
Dislocations of nasal bones and cartilage.
Contusions of the nose.
Nosebleed.
BODY PARTS INVOLVED
Nasal bones and cartilage.
Skin.
Sinuses and eustachian tubes (indirectly, sometimes).
Soft tissue surrounding the injury: eyes, periosteum (covering to bone), nerves, blood vessels, mucous membrane lining the inside of the nose, connective tissue.
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SIGNS & SYMPTOMS
Pain or tenderness in the nose.
Swollen, bruised nose.
Inability to breathe through the nose.
Crooked or misshapen nose (sometimes).
Brisk bleeding or blood oozing from the nostril. If the nosebleed is close to the nostril, the blood is bright red. If the nosebleed is deeper in the nose, the blood may be bright or dark.
Lightheadedness from blood loss.
Rapid heartbeat, shortness of breath and pallor (with significant blood loss only).
CAUSESDirect blow to the nose.
RISK INCREASES WITH
Contact sports, particularly boxing and wrestling. The nose is fairly well protected by a faceguard in football.
Previous nose injury.
Blood disorders, including leukemia and hemophilia.
Use of certain drugs, such as anticoagulants, aspirin, or prolonged use of nosedrops.
Exposure to irritating chemicals.
High altitude or dry climate.
HOW TO PREVENTProtect your nose from injury whenever possible. Wear protective headgear for contact sports or when riding motorcycles or bicycles. Wear auto seat belts.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Self-care (see Continuing Care).
Doctor's treatment or emergency room treatment if self-care is unsuccessful.
Surgery (for severe bleeding only) to tie off the artery feeding the bleeding area.
Surgery, if the nose is crooked or breathing is impaired.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood tests if bleeding is heavy.
X-rays of the nose.
POSSIBLE COMPLICATIONS
Infection of the nose and sinuses.
Shock from loss of blood (rare).
Bleeding severe enough to require a transfusion.
Permanent breathing difficulty.
Permanent change in appearance.
PROBABLE OUTCOME
Minor fractures and contusions with no deformity usually heal in 4 weeks.
Major fractures can be repaired with surgery. If surgery is necessary, it should be done within 2 weeks or not until 6 months after injury.
Most bleeding can be controlled with home treatment. Severe bleeding requires hospitalization.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
Apply ice packs to the nose immediately after injury to minimize swelling and decrease bleeding.
If the nose is deformed or if the nosebleed is heavy or cannot be stopped, obtain emergency medical treatment. Gauze packing may be inserted to absorb blood, stop dripping and exert pressure on ruptured blood vessels. Continued bleeding may require cauterization (See Glossary).
CONTINUING CARE
If surgery is required to set a broken nose or insert a nasal pack, your surgeon will give you postoperative instructions. FOR A NOSEBLEED WITHOUT FRACTURE:
Sit up with your head bent forward.
Clamp your nose closed with your fingers for 5 uninterrupted minutes. During this time, breathe through your mouth.
If bleeding stops and recurs, repeat--but pinch your nose firmly on both sides for 8 to 10 minutes. Holding your nose tightly closed allows the blood to clot and seal the damaged blood vessels.
You may apply cold compresses at the same time.
Don't blow your nose for 12 hours after bleeding stops to avoid dislodging the blood clot.
Don't swallow blood. It may upset your stomach or make you gag, causing you to inhale blood.
Don't talk (also to avoid gagging).
MEDICATION
For minor discomfort, you may use non-prescription drugs such as acetaminophen. Aspirin should not be used because it makes bleeding more likely.
Your doctor may prescribe:
Stronger pain relievers, if needed.
Antibiotics if infection develops.
Drugs to treat any underlying serious disorder.
ACTIVITYResume your normal activities as soon as bleeding stops or other symptoms improve.
DIETAfter surgery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Otherwise, no special diet.
REHABILITATIONRehabilitation exercises must be individualized. Follow your doctor's or surgeon's directions.
CALL YOUR DOCTOR IF
You have a nosebleed that won't stop with self-care described above.
After the nosebleed, you become nauseous or vomit.
After the nose has been packed, your temperature rises to 101F (38.3C) or higher.
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