Broken nose (nasal fracture) emergency department leaflet

A broken nose is common, especially after a fall, a sports injury or a fight. The bones in your nose are the ones in your face that are most often broken because they stick out and do not have a lot of support.

A broken nose usually heals on its own within three weeks. Get medical help if it's not getting better or your nose has changed shape.

We do not usually do x-rays to check whether you have broken your nose as these bones do not show up well. If you do need any x-rays, these will be to check that you have not damaged other parts of your face, such as your eye sockets, cheek bones or jaw bone.

To guide the treatment you need, we will look for certain signs that show you have broken your nose, such as:

• Your nose is obviously misshapen and out of place.
• It wobbles (unstable) and clicks.
• You have cuts around your nose.
• You have swelling and/or bruising around your nose.
• You have had a nose bleed.
• You have a blocked nose.

Should you have any of the below symptoms or signs please let your doctor or nurse know:

• Loss of consciousness, vomiting or loss of memory of the injury. This might suggest a head injury.
• Bleeding from one of your ears.
• If you are taking medications to thin the blood such as Warfarin, Rivaroxaban, Apixaban, etc.
• Clear watery fluid draining from one nostril.
• Bruising around your eyes.
• A swelling in your nasal septum (the piece of cartilage between your nostrils) which may need to be lanced.
• Continuous bleeding from your nose which might mean we have to pack your nose.
• Eye pain, double vision or blurred vision which might mean damage to the bones in your face.
• Neck pain with or without tingling down your arms/legs which may mean you have damaged your neck.
• An injury with glass.

A member of staff will examine your nose to make sure there is no bleeding, no blood clots (haematoma) in your septum and that you can breathe through both nostrils.

If you have a simple break with no problems, we may:

• Advise you to use ice packs and to take painkillers such as paracetamol and ibuprofen, to reduce the swelling and ease any pain.
• Give you a course of antibiotics if you have a cut over the area of the break or you have had a blood clot lanced and drained.
• Ask you to come back to be seen within five to seven days (once the swelling has gone down) for a follow-up appointment to see an Ear, Nose and Throat (ENT) doctor in their outpatient clinic on Level 2 of the Barry Building. At this appointment, the doctor will decide whether you need an operation to reset your broken nose.

If you need an operation, this will be arranged for you about one to two weeks after your injury by the ENT team.

A broken nose usually heals on its own within three weeks.

Take simple pain relief and use ice packs to reduce the swelling around your nose.

If your nose bleeds, pinch the fleshy part of the nose firmly for 20 minutes. Breathe through your mouth and lean forward in a sitting position. Apply cold compresses to your nose, forehead and nape of neck to reduce the swelling. Spit out any blood in the mouth. Seek medical help if the bleeding will not stop.

Do not

• Try to straighten your nose yourself if it's changed shape. See a doctor instead.
• Wear glasses until the swelling has gone down, unless you need them.
• Pick or blow your nose until it's healed.
• Do strenuous exercise for the first two weeks.
• Play sports where your face might be hit for at least six weeks.

Seek medical help if you have persisting pain or nose bleeds, if you feel feverish or if your breathing doesn’t improve once the swelling is reducing.

For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.

• The NHS website provides online health information and guidance.

• NHS 111 phone line offers medical help and advice from trained advisers supported by nurses and paramedics. Available 24 hours a day. Calls are free from landlines and mobile phones.

• There are walk-in and urgent treatment services at Brighton Station, in Crawley and at Lewes Victoria Hospital.

• Patient Advice and Liaison Service (PALS) can be contacted with your comments and concerns, and to provide general support.

This leaflet is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this article is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.