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Nose Emergency

Alternate Names

  • nose trauma
  • nose injury
  • Nasal fracture

Definition

A nose emergency involves a significant loss of blood, injury, or blockage of the nose that interferes with breathing.

Risks

What are the causes and risks of the injury?

Some of the causes of nosebleeds are as follows:
  • being exposed to very cold or very dry air
  • continually blowing the nose
  • doing strenuous exercise
  • foreign bodies in the nose
  • getting hit in the nose
  • having allergies
  • having high blood pressure
  • picking the nose
  • taking large doses of aspirin or other blood-thinning medications
  • using nasal sprays that dry the mucosa
A foreign body in the nose may be caused by the following:
  • deliberately inserting a small object, such as a bean, into the nostril
  • having the airway packed in a healthcare setting
  • playing or roughhousing
A nose fracture may be caused by the following:
  • being flung into a hard object, such as in a motor vehicle crash
  • being hit on the side of the nose, such as in a fistfight
  • running into a hard object, such as another player's helmet during football

Prevention

What can be done to prevent the injury?

The following measures can help to prevent nose emergencies from the various causes:
  • Avoid excessively dry air or very cold air.
  • Avoid picking the nose.
  • Avoid large doses of aspirin or other blood-thinning medications, except as directed by a healthcare provider.
  • Avoid placing any foreign bodies into the nostrils.
  • Avoid roughhousing.
  • Avoid situations that can result in trauma to the nose.
  • Control high blood pressure.
  • Decrease frequent nose blowing with control of allergies.
  • Follow sports safety guidelines for children, adolescents, and adults.
  • Keep the nasal lining, also called mucosa, moist.

Diagnosed

How is the injury recognized?

The diagnosis of a nose emergency begins with a medical history and physical exam. An X-ray may be ordered if a nose fracture is suspected.

Treatments

What are the treatments for the injury?

The treatment varies, depending on the type of nose emergency.
Nosebleed
1. Keep the person calm. Have the person breathe slowly through the mouth.
2. Direct the person to 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 5 to 10 minutes. Often this is successful in stopping the bleeding.
4. Apply cold compresses to the nose to help reduce swelling and also slow down bleeding.
5. 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 tweezers, 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.
Nose fracture
1. Keep the person calm.
2. 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.
3. Apply cold compresses to the nose to help reduce swelling and also slow down bleeding.
4. Consider pain medication, including acetaminophen or ibuprofen.
5. Do not try to straighten a broken nose. Seek medical attention right away.

Side Effects

What are the side effects of the treatments?

Improper compression, positioning, and sometimes pinching too hard can actually damage the nose.
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 affect the ability of the eye muscles to move the eyes properly.

After Treatment

What happens after treatment for the injury?

Nosebleeds usually go away without continuing difficulty. 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 recovers well.
Nose fractures generally heal without the need for surgery. The fractures can be significant enough to cause airway blockage, which may require surgery. Occasionally, a person is left with some permanent deformity. Any new or worsening symptoms should be reported to the healthcare provider.

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