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nose emergencies

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Nasal fracture

Alternative Names 
nosebleeds, broken nose, foreign body in nose

Any event involving severe loss of blood through the nose or the fracturing of bones in the nose is considered a nose emergency. Nose emergencies can also occur when an object is lodged in the nose preventing the person from breathing.

What are the signs and symptoms of the injury? 
Nosebleeds can involve:
  • bleeding from one or both nostrils.
  • bleeding into the back of the throat.
  • coughing up blood that has drained into the back of the throat.
  • gagging.
  • feeling of fullness in the ears.

A foreign body lodged in the nose usually involves:
  • feeling pain or irritation with the sensation of something in the nostril.
  • tearing.
  • sneezing.
  • difficulty breathing through the clogged nostril.
  • one-sided nasal discharge and a foul-smelling breath
A fracture of the nose usually involves:
  • feeling pain along the bridge of the nose and area between the eyes.
  • bleeding from the nose.
  • bruising around or under the eyes.
  • deformed appearance of the nose.
  • swelling.
  • history of trauma.

What are the causes and risks of the injury? 
Nosebleeds may be caused by:
  • continually blowing the nose.
  • picking the nose.
  • using nasal sprays that dry the mucosa.
  • taking large doses of aspirin.
  • having high blood pressure.
  • having allergies.
  • doing strenuous exercise.
  • being exposed to very cold air.
  • being exposed to very dry air.
  • getting hit in the nose.
  • foreign bodies in the nose.
A foreign body in the nose may be caused by:
  • playing or rough housing.
  • having the airway packed in a healthcare setting.
A nose fracture may be caused by:
  • trauma or injury to the nose.
What can be done to prevent the injury? 
  • Keep the nasal mucosa (lining) moist.
  • Avoid excessive dry air or very cold air.
  • Avoid trauma.
  • Avoid large doses of aspirin.
  • Control high blood pressure.
  • Decrease frequent nose blowing with control of allergies.
  • Avoid roughhousing.
  • Avoid placing any foreign bodies into the nostrils.
  • Avoid situations that can result in trauma to the nose.
Avoid picking the nose frequently.

How is the injury diagnosed? 
Nosebleeds are diagnosed when blood continuously drips from the nostrils or is present in the back of the mouth. Foreign-body blockage may be diagnosed by the feeling of having something in the nose. A foreign body will often be seen high in the nasal passage of children in whom a bad smell is noticed coming from the nose or mouth. Fracture is diagnosed by history, pain in the nose, x-ray findings and appearance of the deformity.

What are the treatments for the injury? 

1. Keep the person calm. Have the person breathe slowly through the mouth.

2. Direct the person either sit or stand upright and lean forward slightly. This helps prevent blood from going down the back of the throat, causing blockage. This will also help slow blood flow from the veins of the nose.

3. Stop blood flow by pinching the nose with the thumb and index finger while breathing through the mouth. It is important to apply this direct pressure for five to ten minutes. Often this is successful in stopping the bleeding. Cool compresses applied to this area are helpful as well.

4. If the person's nose continues to bleed 15 minutes after changing the person's position and applying direct pressure and cool compresses, get medical help.

Foreign body in the nose:

1. Encourage the person to breathe slowly. Any sudden or deep breath could force the object further into the nose.

2. Gently press the other nostril closed and have the person blow through the affected nostril, if it is known which nostril the foreign object is in.

3. Avoid blowing the nose too hard or repeatedly.

4. Seek medical help if the above method fails. Do not try to get the object using forceps, even if it is visible deep up in the cavity.

5. Do not attempt to remove an object that is not easy to see and grasp. Doing so can push the object further up the nose.

Fractured nose:
  • Keep the person calm.
  • Have the person breathe slowly through the mouth and lean forward in a sitting position. This helps to prevent blood from going down the back of the throat. It also helps slow the blood flow.
  • Apply cold compresses to the nose to help reduce swelling and also slow down bleeding.
  • Consider analgesia, including paracetamol or ibuprofen.
  • Do not try to straighten a broken nose. Seek medical attention right away.
What are the side effects of the treatments? 
Improper compression, positioning, and sometimes pinching too hard can actually damage the nasal lining and the septum, or the area between the nostrils. Trying to remove a foreign object lodged in the nostril can actually lodge it more firmly. Any attempt to straighten a broken nose could cause further injury, which may seriously involve the eyes and their movement.

What happens after treatment for the injury? 
Considering the cause, nosebleeds will usually not recur if proper care is taken, such as avoiding trauma, extreme weather changes, and nasal sprays, or reducing high blood pressure. Sometimes recurring nosebleeds require surgery. When a foreign body is removed from the nose, the nasal lining may become inflamed. However, once the object is removed, the person usually does well.

Fractures of the nose generally heal without need for surgery. The fractures can be significant enough to cause airway blockage, which may require surgery. In some cases, there can also be some permanent deformity.

Author: James Broomfield, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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