How to Tell if Your Child's Nose is Broken
It can happen just as easily as it did years ago when Marcia got hit in the nose with the football on the Brady Bunch. It can be from falling down and smacking their face, a ball caught by the nose instead of the glove, or even running into a doorknob nose first. There are numerous situations that can happen to kids that result in parents wondering if their child broke their nose and what to do. Thankfully kids are resilient and heal rather quickly. Here is what you should do if your child runs in the house screaming in pain with blood gushing from the nose.
How to Stop a Nosebleed in a Child
First, have your child sit down and hold his head straight and lean slightly forward. Don't lie down as this will cause blood to run down the throat and can cause nausea and vomiting. Place gauze or tissues on the nose and gently pinch the nostrils closed with minimal pressure. Replace the tissues as many times as needed until bleeding stops. Applying an ice pack to the lower forehead can also help. After the nosebleed has stopped, have the child remain seated and rest to prevent bleeding from starting up again. It's a great time to watch a movie for a while and settle down. Do not clean out the nostrils for several hours or it may dislodge blood clots and cause bleeding to return.
Signs of a Broken Nose in Children
- Tenderness in the facial area surrounding the nose
- Bruising under the eyes (black eye)
- Obviously crooked nose
- Crunching or creaking noise when touching nose
- Difficulty breathing through nose
When to Go to the Doctor For a Nose Injury
Typically a nose injury results in lots of swelling which can make it hard to determine if the nose is truly broken, especially in a child since their noses are naturally less pronounced. Unless it is an obvious contorsion, the standard procedure is to delay a correction until the swelling goes down. That being said, if you experience any of the following with your child, you should go ahead and get medical attention.
- Major bleeding that can't be stopped
- Nose is severely deformed or obviously crooked
- Breathing is restricted
- Stitches are needed for external deep cuts
- Fluid (not blood) draining from the nose
Although X-rays can be performed, the nose is mainly cartilage and injuries to cartilage do not show up on X-rays. X-rays can be useful to determine if the bridge of the nose or portions of the cheekbone are fractured. If after the swelling subsides and the nose still looks crooked, an ear nose and throat (ENT) specialist can reset or realign the nose in an office procedure using anesthesia. Typically if there are no issues with breathing and the sinuses are not affected, this procedure is not done unless it is desired for cosmetic purposes. Most likely, unless you witness the above symptons, a trip to the doc is not needed. However, if you are in doubt and worried, go ahead and get it checked out.
Common Causes of a Broken Nose
According to the Mayo Clinic, the most common causes of a broken nose in children are:
- Sports Injuries, especially football and hockey
- Motor Vehicle Accidents
- Physical Altercations (in older children and adults)
How to Treat a Child's Nose Injury at Home
After stopping the nose bleed, apply ice to the nose area. A bag of frozen vegetables wrapped in paper towels works great for this. Ice the nose for at least 15 minutes to reduce swelling. You can continue to apply ice treatments over the next several days. Over the counter medications such as Tylenol can be given for pain, but remember not to give aspirin to kids under twelve do to the risk of Reyes disease. Sometimes it is also helpful to elevate the head when sleeping.
Your child's nose may remain sore and swollen for several days. Try to avoid excessive physical activity and another blow to the nose dueing this time.
My Daughter's Experience
My daughter got smacked in the nose with a basketball thrown at close range. Her nose was gushing blood. The nosebleed stopped after about 10-15 minutes. I applied ice to the top of her nose as I could see lots of swelling. I gave her Tylenol for the pain and kept her activities limited for the rest of the day. I suspected her nose may be broken due to the amount of pain and swelling she had. The swelling continued for several days. On day eight, her nose looked slightly crooked to me. Day nine she had two bad nosebleeds, just from running. She encountered no additional bumps to the nose. That was it.....we were off to the doctor. I was convinced her nose was broken. I was upset thinking my daughter had broke her nose and I waited so long to take her to the doctor.
Turns out the doctor said he wouldn't have treated her nose any differently had I taken her in earlier. He said many people have fractures to the nose and choose not to treat it. The doctor acknowledged the slight crookedness and noted how tender her nose still was. He also thought she still had a good deal of swelling. His first question was if she had difficulty breathing out of her nose. Since that answer was no, he said there was no medical reason to have her nose reset. He gave me the option of having an X-ray performed just to rule out any fracture in the bony part of the nose, or a deviated septum. The mom in me chose to have an X-ray done, even though I knew it likely wasn't necessary. As expected, the X-ray was inconclusive. However, It did rule out a fracture in the bony part and the septum of the nose. The doctor advised me to continue apply ice a little bit every day until the swelling was gone. He told me to wait until the swelling was completely gone and then decide if we wanted to go to an ENT to have it evaluated and possibly reset if it was still crooked. Eventually, the swelling went away, but it took much longer than I thought. The crookedness subsided with the swelling.