First Aid and Treatment for Broken Noses

The nose is the most commonly broken bone in the head. Broken noses are almost always the result of facial trauma. Symptoms include pain, visible deformity, bloody nose, and in severe cases difficulty breathing and bruising around the eyes or "black eyes." A broken nose can cause a deviated septum.

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First Aid for Broken Noses

If you think you might have a broken nose, you need medical attention. In the meantime, these are the things you need to do:

• Breathe through your mouth.
• Do not move if it is possible that there could be damage to your neck or spine. Have someone else call 911.
• If your neck is okay, lean forward and gently pinch the nostrils together. This will help to stop the bleeding and prevent blood from running into the back of the throat and being swallowed.
• Apply a cold compress to help control pain and swelling.
• You may use acetaminophen to control pain, or a healthcare provider may prescribe something stronger. Inform your healthcare provider of any over-the-counter pain relievers you took before coming to the clinic or ER.

When Is a Broken Nose an Emergency?

Broken noses are a medical emergency if:

• You cannot control bleeding
• You have difficulty breathing
• Other serious injuries are suspected, especially injuries of the spine or neck
• A significant amount of clear fluid is draining from the nose
• There are large blood clots coming out of the nose
• The skin or nasal passages of the nose turn black

Diagnosing a Broken Nose

It may be surprising to know that x-rays are not particularly helpful in diagnosing a broken nose. The diagnosis is typically made based on the appearance of the nose and whether or not you are having difficulty breathing.

Medical imaging such as X-rays or CT scans is sometimes done to rule out other fractures of the head or neck, depending on the injury.

Treatment Options for a Broken Nose

Many fractures do not need to be repaired, and just need time to heal. That is because a fracture of the nose might not have caused the bone to move out of place. The bone will need to be reset (put back into place) only if there is obviously physical deformity, or the injury is interfering with breathing.

Complications and Surgery

There are some serious complications of a broken nose. A septal hematoma (a blood-filled collection) may form (most often within 24-48 hours of the injury). If it is not drained in a timely manner, it can result in tissue death and cause the nose to collapse.

Sometimes surgery is necessary to repair these types of problems. After a broken nose, you might need surgery to reset the bone, repair a deviated septum, repair a tear in the meninges, or remove excess blood.

If the bone does need to be reset, there are a couple of options, and the right one for you depends on the situation. In some cases, the bones can be reset in the healthcare provider's office with a local anesthetic. The bones are then held in place with a cast, which remains in place for about a week.

Healing

If you don't need your bone to be reset, or after you've had surgery, your healthcare provider may recommend that you avoid any activity that could result in a facial injury. You would need to keep your activity light for about six weeks while your nose heals. You must be very careful during this time to avoid having your nose bumped or hit.