Suspected broken nose

Patient Information Leaflet

Introduction

This leaflet is for people who may have a broken nose. It includes information about what causes a broken nose, what happens in the Emergency Department (ED) and how it is treated.

How common is a broken nose?

It is extremely common. Fractures (breaks) of the nose account for:

• One out of every three fractures (all fractures).
• Four out of every 10 facial fractures.

What causes a broken nose?

The nose is formed of both bone and cartilage (see figure 1). It is naturally vulnerable to injury because it sticks out and does not have a lot of support.

It can be broken by direct trauma, for example, falls, assaults and blows from contact sports.

How do I know if my nose is broken?

It will be painful and swollen. Other typical symptoms include:

• The nose looks misshapen and deformed.
• A nosebleed.
• Bruising around the eyes (black eyes).
• A painful nose when you touch it.
• A crunching or crackling sound when you touch the nose.
• Difficulty breathing out of the nose, as if something is blocking it.

You do not always need hospital treatment for a broken nose, particularly if the skin and septum (the inside part separating the nostrils) is still intact.

However, if other facial bones or the septum are damaged, this may need medical or surgical treatment.

What should I do if I think my nose is broken?

You can carry out first aid as follows:

First aid (at scene of injury)

A nosebleed is very common after an injury to the nose. First aid for a nosebleed is:

• Breathe through the mouth and lean forward to keep blood from going down the back of the throat.
• Spit out any blood in the mouth. Avoid swallowing any blood as this may make you vomit (be sick) later.
• Firmly pinch the fleshy part of the nose for at least two minutes.

Note: it is essential to keep the pressure constant; do not release the nose until the two minutes have passed.

• If bleeding does not stop after two minutes of direct pressure, re-apply the same pressure and add an ice pack to bridge of nose.

Injuries to the nose can be extremely distressing and painful, therefore:

• Do not pack the nose with tissue.
• Take painkillers like paracetamol or ibuprofen, if you can take them (always read the label; do not exceed the recommended dose).
• If possible, apply a cold compress or covered ice pack to the nose.

Symptoms of concern: visit the nearest Emergency Department urgently if:

• Your nose continues to bleed despite completing the correct first aid (described above); or if you are unable to complete the first aid.
• Your nose is very deformed or misshapen.
• Clear fluid is draining from your nose.
• You suspect a blood clot in the septum – you see a cherry-red, shiny lump on the middle structure of the nose.
• You have additional injuries, such as facial wounds.

What happens in the Emergency Department?

• You will be seen by an Emergency Department clinician.
• You will not require an X-ray of your nose. It will not alter your treatment.
• You will be assessed for any other injuries related to a head and or facial injury.
• We will give you treatment for a persistent nose bleed, if you have one.
• We will offer you simple painkillers, as required.
• We will give you advice on pain relief and treatment for the potential fracture.
• A check will be made to see if you have a clot in your septum which would be at risk of infection.

What follow up will I need after leaving the Emergency Department?

If an urgent review by the ear, nose and throat (ENT) specialist has been organised by the Emergency Department clinician, you will be given written and verbal instruction about this before leaving the Emergency Department.

If you have not been given specific follow-up arrangements, complete the checklist below once the swelling has gone down or one week after your injury (whichever is sooner).

Checklist

If you have answered ‘No’ to the entire checklist above, you will not need any further treatment.

A broken nose heals in four to six weeks. Avoid knocking your nose during this time (e.g. by playing contact sports).

If you have answered ‘Yes’ to any question in the checklist, you can access the ENT team by contacting them directly:

Telephone: 01384 456111 ext. 2372 (Monday to Friday, 8am – 4pm)

Email: dgft.entemergency@nhs.net

Can I find out more?

You can find out more from the following weblink:

NHS Choices: https://www.nhs.uk/conditions/broken-nose/

If you have any questions, or if there is anything you do not understand about this leaflet, please speak to one of our nurses. If you need help when you return home, please contact your GP.

If you have any feedback on this patient information leaflet, please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Joanne Taylor Date reviewed: January 2021 Next review due: August 2026 Version: 4 DGH ref: DGH/PIL/00908