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NASAL FRACTURE IN CHILDREN

(EPISTAXIS)
Nasal Fracture in Children

WHAT YOU NEED TO KNOW:

What is a nasal fracture? A nasal fracture is a crack or break in your child's nose. Your child may have a break in the upper nose (bridge), the side, or in the septum. The septum is in the middle of the nose and divides his nostrils. Nasal fractures are caused by a hard hit to the nose. They may be caused by a motor vehicle crash, sports injury, or a fall.

What are the signs and symptoms of a nasal fracture?

  • Pain and swelling

  • Nosebleed

  • Deformed nose

  • Crackling sound when your child's nose is touched or moves

  • Bruising on your child's nose or under his eyes

How is a nasal fracture diagnosed? Your child's healthcare provider will ask you and your child when, where, and how the injury occurred.

  • A nasal exam will be done to check your child's injury. Your child will be given pain medicine before his healthcare provider touches and looks at the outside and inside of his nose. He will remove blood clots and check for large hematomas (collections of blood).

  • An x-ray or CT may show the nasal fracture. You may be given contrast liquid before the scan. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is a nasal fracture treated?

  • Medicine may be given to your child to decrease pain or help prevent a bacterial infection. Ask how to give pain medicine to your child safely. Medicine may also be given to decrease nasal swelling and help make breathing easier for your child.

  • Wound care may help stop bleeding. If your child has a hematoma (collection of blood) inside his nose, it will be drained. Healthcare providers may place packing (gauze or other material) inside the nose to soak up blood.

  • Closed reduction may be done to put your child's nasal bones back into the correct position. Local or general anesthesia is used during this procedure. This procedure may be done right away or several days after his injury when the swelling has decreased. Surgery (open reduction) to put your child's bones back into place may be needed for severe fractures.

  • A splint or packing may be used to help keep your child's nose in place for 7 to 10 days after reduction. Ask your child's healthcare provider to show you how to care for his splint or packing.

How do I care for my child's nasal fracture at home?

  • Apply ice on your child's nose for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue.

  • Keep your child's head elevated when he lies down to help decrease swelling. Ask how you can keep your child's head elevated safely. Your child may need to return for tests or closed reduction after his swelling has decreased.

  • Protect your child's nose to prevent bleeding, bruising, or another fracture. Your child should avoid bumping his head on anything. Ask your child's healthcare provider when he can return to physical activities such as sports.

When should I seek immediate care?

  • Your child feels like one or both of his nasal passages are blocked and he has trouble breathing.

  • Your child has severe nose pain, even after he takes medicine.

  • Clear fluid is leaking from your child's nose.

  • Your child has double vision or has problems moving his eyes.

When should I contact my child's healthcare provider?

  • Your child has a fever.

  • Your child continues to have nosebleeds.

  • Your child has a headache that is getting worse, even after he takes pain medicine.

  • Your child's splint, drain, or packing is loose.

  • You have questions about your child's condition or care.

CARE AGREEMENT:

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