DESCRIPTIONNose injuries include fractures of the nasal bones, dislocations of nasal bones and cartilage, contusions of the nose, and nosebleed. Appropriate health care includes: self-care (see HOME 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.
SIGNS & SYMPTOMSPain or tenderness in the child's nose.
A swollen, bruised nose.
Inability to breathe through the nose.
Crooked or misshapen nose (sometimes).
Brisk bleeding or blood oozing from the nostril. If the child's 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).
Direct blow to the child's nose.
Contact sports, particularly boxing and wrestling; 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.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should protect the nose from injury whenever possible. Urge your child to wear protective headgear for contact sports or when riding motorcycles or bicycles.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory blood tests if bleeding is heavy; X-rays of the child's nose.
POSSIBLE COMPLICATIONSInfection of the nose and sinuses; shock from loss of blood (rare); permanent breathing difficulty or change in the child's appearance.
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.
Apply ice packs to the child's nose immediately after injury to minimize swelling and decrease bleeding.
If the child's 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).
If surgery is required to set your child's broken nose or to insert a nasal pack, your surgeon will give you postoperative instructions.
Instructions for your child for a nosebleed from injury 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.
Don't talk, to avoid gagging.
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.
Apply cold compresses at the same time.
Don't swallow blood. It may upset your stomach or make you gag, causing you to inhale blood.
Don't blow your nose for 12 hours after the bleeding stops to avoid dislodging the blood clot.
MEDICATIONFor minor discomfort, use non-prescription drugs such as acetaminophen. Don't give the child aspirin, which can aggravate bleeding.
Your doctor may prescribe stronger pain relievers, if needed; antibiotics if infection develops; drugs to treat any underlying serious disorder.
Your child can resume normal activities as soon as the bleeding stops or other symptoms improve.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has a nosebleed that won't stop with self-care described above.
After the nosebleed, your child becomes nauseous or vomits.
After the nose has been packed, your child's temperature rises to 101F (38.3C) or higher.