Many nasal injuries are of a low risk nature, they are often treatable with first aid care and only the more severe require further medical attention

The most common of nasal injuries include nose bleeds, broken nose, fractured nose (Bony fractures of the nose account for nearly 50% of all facial fractures), dislocated nose, airway blockage from bleeding fluid discharge or tissue swelling, nasal obstruction and infection of broken skin on the nose.

 Less common, and far more series nasal conditions or complications from nasal injuries include septal hematoma, series infection resulting in brain abscess and series complications of nose bleeds

The common nasal injuries are usually caused by some form of trauma to the nose, this doesn’t have to be extreme trauma to cause some form of nasal injury, a bleeding nose can even be caused by extreme heat. Therefore the nature of nasal injuries in general can be treated as low risk because they rarely have dangerous complications and can be fixed by first aid. Nasal injuries are very treatable and some can even be treated by the victim themselves with the appropriate steps

Generally speaking, trauma to the nasal area commonly results in the following signs and symptoms, they are combined because often the first signs of nasal injury and the symptoms that occur from them, because they are usually caused by trauma, it is usually physically noticeable when a nasal injury has been experienced;

PAIN SWELLING AIRWAY OBSTRUCTION EPISTAXIS (profuse bleeding from the nose)

CREPITANCE (the crackling heard and the sensation felt when broken bones are moved over each other)

ECCHYMOSIS (a purplish area of the nose resulting from fracture and caused by extravasation of blood into the skin)

SEPTAL HEMATOMA (a mass of extravasated blood that confined within the nasal septum)

RHINITIS (an inflammation of the mucous membranes that line the nasal passages)

NASAL VESTIBULAR STENOSIS (a narrowing of the nasal passages)

Nasal trauma can lead to complications of more series injuries or conditions. After experiencing facial trauma if you experience any of the following seek urgent medical care; a loss of consciousness, vision problems or extensive periorbital swelling, occlusal abnormalities, or facial paresthesias (infraorbital nerve damage) , persistent brisk epistaxis despite pressure, elevation, and nasal decongestants.

WHAT IS A NOSEBLEED? The nasal septum is the tissue which divides the nostrils; it is the front of the nasal septum and is where most nose bleeds originate.

Great force is not required to initiate a nose bleed, and most common nose bleeds are harmless and easily treatable. These types of nosebleed can occur when the this tissue becomes irritated by minor infection, drying out, light trauma to the nose or even picking the nose.

When a nose bleed occurs from minor trauma and the victim is not suffering from any further injuries or experiencing pain, the nosebleed can be controlled with a few simple steps. One of the most important steps to controlling a nose bleed is the application of pressure in the correct position. For the average nosebleed, these steps should be followed;

When treating a patient for ANY nasal

injury, you first need to go through DRABCD

Is there any danger to you, bystanders or the victim, is the victim responsive, are the airways clear, are they breathing, are the conscious?

You must always conduct a PRIMARY SURVEY (for ALL nasal injuries)

Do not obstruct the nose with foreign objects in order to try and control or stop the bleeding such as gauze or tissue.

Complications arise from nose bleeds in situations like if the victim is on blood thinner medication which can potentially cause drastic consequences if the bleeding is not controlled immediately.

Another more serious type of nosebleed is a rarer form called posterior epistaxis which means that the bleed originates from the back section of the nose.

This can then cause a concernedly large amount of blood to travel down the back of the throat, this type of nose bleed requires professional medical treatment

“A broken nose is any crack or fracture in the bony portion of the nose” A broken nose is causedby trauma to the nose or face which is strong enough to result in a breakage of the nasal bones. Often a broken nose is not a serious issue, many nose breakages are healed easily or may result in a slightly crooked appearance but without any medical issues. The first aid style of treatment may not be enough for nose

breakage resulting from series nasal trauma, but this may be more due to the intensity of the trauma rather than the breakage, if treatment if performed and victim is still in pain or symptoms have not made any change or have worsened a medical professional need to be sought out immediately.

Possible complications from a broken nose which are not very common include;

“Infection of the nose, sinuses, or facial bones (which is treatable by a doctor and antibiotics), permanent breathing difficulty, persistent drainage from one or both nostrils - this may be caused by cerebral spinal fluid draining from the brain into the nose (CSF rhinorrhea) and can occur after a head injury or after surgery on the nose or ears.

Other complications include; change in the appearance of the nose or the tip of the nose, crooked (deviated) nasal septum, a hole in the nasal septum (septal perforation) or causing the bridge of the nose to collapse (saddle nose deformity), a large amount of blood in the nasal septum (nasal septal hematoma) and a change in or loss of sense of smell.”

The symptoms of a common variation of broken nose are sometimes symptoms associated with other nasal injuries, and these symptoms can combine other conditions, e.g. the symptom of a broken nose can be a nosebleed. Signs and symptoms include;

The first aid and immediate treatment on a broken nose can be dealt with easily, both the person treating the victim and victim need to remain calm.

The victim should be assessed to ensure that the symptoms are all ones of a low grade nature and do not involve lack of consciousness from trauma or difficulty breathing.

If there is difficulty breathing emergency medical aid needs to be called and the person tending to the victim would need to place the victim in the recovery position to help clear their airways and then if they stop breathing complete CPR, most often the only need for this would be because of the trauma which cause the nasal injury, causing other injuries, a nasal injury should not result in unconsciousness or require CPR

For simple fractures, where the bone is still in its natural position, treatment usually involves pain medication and nasal decongestants.

When the nose has been “broken”, treatment is usually undergone by a doctor or specialist after the swelling from trauma has gone down which usually takes between 2-7 days.

Then the nose will be set, and nasal packing may be inserted

In some cases a splint will need be applied. If packing has been used the doctor will often issue a course of antibiotics to prevent infection

Nasal obstructions can be as simply as the result of a curious child placing a foreign object in their nasal passage and then not being able to take it out

A nasal blockage is usually easily treated, but most often should be treated by a doctor who is more trained than a basic first aider

This is because a simple blockage could be potentially harmful if removed incorrectly as it can damage fibrous tissue or cause cuts inside the nose which could get infected.

A doctor may sometimes prescribe antibiotics after the removal of foreign objects from the nose if there is any sign or indication of infection or potential infection so the situation does not go untreated and becomes worse.

Symptoms are not usually extreme and usually include difficulty breathing, “persistent unilateral nasal obstruction and discharge, which may be bloody and accompanied by an offensive odour”.

Depending on the foreign body and the manner in which it became placed in the nose, nasal radiography may be required but usually a doctor will be able to simply remove the obstructive material with surgery tools.