Nasal Fracture

WHAT YOU SHOULD KNOW:

Nasal Fracture (Inpatient Care) Care Guide

  • A nasal fracture (FRAK-chur) is also called a broken nose. This occurs when any of the bones of your nose are broken. Nasal fractures are the most common fractures of the face. This happens because the nose is a prominent part of the face. The nose is the main gateway to the respiratory (breathing) system. Nasal fractures may be caused by an injury or trauma to the face. A direct blow to the nose during a fight, physical abuse, or a car accident may cause nasal fractures.
    Picture of a normal nose


  • Common signs and symptoms may include a bump, cut, bruise, swelling, or deformity on your nose. You may also have trouble breathing, smelling, or talking. A nasal endoscopy or nasal speculum exam may be used for diagnosis. Other tests, such as x-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scan, may also be done. Treatment may include medicines for the relief of symptoms, or surgery if the fracture is bad. Most nasal fractures heal fast without further problems. With treatment, care and follow-up, your nasal fracture can heal, and its symptoms relieved.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment for a nasal fracture may cause unwanted side effects. Medicines may cause you to have nausea (upset stomach) or vomiting (throwing up). You may bleed or get an infection if you have surgery. If left untreated, the fractured bones may deform your nose even more, and cause more problems. Permanent injuries, such as nerve damage or trouble breathing, may also happen. Diagnosis and treatment of your nasal fracture as soon as possible is very important. Call your caregiver if you have concerns about your fracture, medicines, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

At first you may need to rest in bed. You may need to breathe through your mouth or lean forward especially when sitting. You may use 2 to 3 pillows when you lie down. This will help you breathe easier. Your caregiver will tell you when it is OK to get you out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away.

Ice:

An ice pack may be applied to your skin on top of the swollen part of the nose to decrease swelling. An ice pack is made of crushed or cubed ice in a plastic bag or an ice pack. Some water is mixed in a bag with the ice to more evenly distribute the cold. Wrap the ice bag in a towel. Do not place the ice bag directly on the skin. Do not leave the ice pack on the skin for a long time to avoid skin damage.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may need one or more of the following:

  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.

  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up).

  • Nasal decongestants: This medicine decreases the swelling in the nose to make breathing easier.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    .
  • Tetanus shot: This medicine keeps you from getting tetanus, and may be given if you have an open wound. It is given as a shot. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.

Mouth care:

You may need to clean your mouth everyday. Cleaning your mouth will remove pieces of food or dried blood, and clean your teeth. A water pik or a small soft toothbrush will work well to clean your mouth. Ask your caregivers for more information about proper mouth care.

Oxygen:

You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. Oxygen may also be given through an endotracheal (ET) or tracheostomy tube. An ET tube goes into your mouth while a tracheostomy tube through a cut in the front of your neck. Both tubes go into your windpipe to help keep your airway open and help you breathe. They are hooked to the ventilator (breathing machine).

Neurologic signs:

Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check your eyes, your memory, and how easily you wake up. Your hand grasp and balance may also be tested. This helps tell caregivers how your brain is working after an injury or illness. You may need to have your neuro signs checked often. Your caregiver may even have to wake you up to check your neuro signs.

Tests:

You may be given a dye before the pictures are taken on some of these tests. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions. You may need any of the following:

  • Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.

  • Nasal endoscopy: This test, also known as anterior rhinoscopy, uses a scope to see the inside of your nose. A scope is usually made of a long, bendable tube with a light on the end of it. During a nasal endoscopy, pictures are taken by a small camera attached to the scope.

  • Nasal speculum exam: Caregivers will use bright light and an instrument called speculum to check the inside of your nose. The speculum gently spreads open your nostrils to look for any blood clots or swelling.

  • Other tests:

    • X-rays: You may need to have x-rays of your nose, face, and head taken to check for broken bones.

    • Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your nose, face, and head.

    • Ultrasound: An ultrasound is a simple test that looks inside of your body. Sound waves are used to show pictures of your organs and tissues on a TV-like screen.

Anesthesia:

Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment. An adult may need to drive you home and stay with you after you have had anesthesia.

Treatment options:

You may need any of the following:

  • Closed reduction: Caregivers may realign the broken bones or bring the nose back to its original position. This is done by moving the nasal bones and septum without opening the skin.

  • Device: Your nose may need to be fixed or supported with splints. A splint may be placed inside or over the top of your nose.

  • Irrigation and debridement: This is done to clean and remove objects, dirt, or dead tissues from the fractured area.

  • Nasal packing: Caregivers may pack your nose with gauze (bandage) strips to control bleeding and prevent infection. These strips are moistened (wet) with salt solution or antibiotic ointment.

  • Surgery: You may need surgery to return the bones to their normal position if the fracture is bad. Surgery may also be needed to correct a deformity or fix damaged tissues in the nose. Blood clots in the nose may be removed by making a small incision (cut) in your nose. Injury to the other parts of the nose, nerves, or blood vessels may also be treated with surgery.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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