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Guidelines for Fractured Nose
Step 1
- Establish injury mode of impact and confirm fracture.
- Stop bleeding with cautery - silver nitrate or packing
Step 2
- Exclude other fractures especially to zygomatic arch, maxilla and mandible and orbital rim - by palpation or by x-ray
Step 3
- Exclude septal haematoma - palpate with cotton bud or blunt instrument.
- Septal haematoma needs urgent referral.
Step 4
- Establish external deviation +/- septal devotion - refer
Step 5
- Refer all patients - especially when swollen and difficult to establish deviation
Step 6
- Refer new fracture and old fracture - immediate or late