Toddlers run, jump, arrange comic brawls, while often getting on the nose. His most common injuries are bruises and fractures. So parents need to be always ready to be able to quickly and effectively help the child eliminate the effects of damage.
How to act in this case and how to distinguish a contusion from a nose fracture?
The most common injury to the nose is a bruise. Since this affects only soft tissue, parents prefer not to go to the doctor.
And it is in vain: the final diagnosis can only be made by a doctor! Only an otolaryngologist will be able to distinguish a bruised nose from a fracture.
But, before taking the victim to the doctor, you need to try to understand what happened and, if necessary, stop the bleeding.
Pay attention to the following symptoms: pain in the nose, which increases with touch, swelling, bruise on the nose and around it. If the mucous membranes and skin are damaged, a bruise may be accompanied by nosebleeds.
Help. First of all, calm down and calm the child, explain to him that you need to sit down or stand quietly: moving and blowing out only intensifies the bleeding. If the bleeding is weak, then perhaps nothing else to do and will not be required.
Usually such troubles disappear on their own within 3-5 minutes, without help. In place of injury, you can apply a cold compress (on the first day after the injury) and press the wings of the nose to the nasal septum.
If the bleeding does not stop:
- Plant the child so that the torso is tilted slightly forward. The baby can also be laid by placing 2–3 pillows under the head so that the head is above the torso. This does not stop bleeding, but it is important that the blood does not enter the respiratory tract or the gastrointestinal tract. The first is fraught with inflammation of the respiratory system and even breath holding. In the second case, the child may begin vomiting, due to which the bleeding will only increase.
- Apply a cold (cloth moistened with cold water, ice wrapped in a soft cloth) to the nose bridge.
- Twist the flagella from the cotton wool, moisten them in a 3% hydrogen peroxide solution, and insert them into the nostrils for 30–40 minutes.
- If all else fails and bleeding lasts longer than 30 minutes or resumes, call an ambulance.
Even if the nose was not very badly damaged, you coped with the bleeding yourself or it did not exist at all, visit the otolaryngologist. The doctor will make a rhinoscopy (examination of the nasal sinuses) and make sure that there are no internal hemorrhages and hematomas, the bones of the nose are not displaced, the cartilage is not damaged.
He may also advise you to apply ice compresses to the injured site every 2 hours for 10–15 minutes during the first 48 hours after the injury, and starting from the third day he will receive warmth and prescribe physiotherapy to remove soft tissue swelling. If a nasal fracture is suspected, an X-ray or computed tomography is performed.
In case of a nose fracture, cartilage and bone are damaged. First of all, carefully inspect the affected nose: normally, its back should be located in the middle of the face, the rays (wings) of the nose should be symmetrical.
If you notice an offset, immediately contact the otolaryngologist or call an ambulance. However, a fracture of the nose can be without displacement of the bones.
Sometimes a fracture is also accompanied by fever.
Symptoms You can suspect a fracture if: there is bleeding, when you press the nose, the child complains of pain, swelling and bruising occurs at the fracture site and under the eyes, nasal breathing is difficult for the child, the shape of the nose has changed.
Help. Before the arrival of ambulance doctors:
- Seat the child.
- Try to keep him calm. Movement can trigger the movement of the bones of the nose or septum.
- Attach to the affected area cold.
- When bleeding can be dripped into the nose vasoconstrictor drops.
- If the blood cannot be stopped, twist the cotton strands from the cotton, moisten them with a 3% hydrogen peroxide solution and insert into the nostrils.
The victim must be examined by a doctor. After all, in addition to the nose, other organs can also be damaged: the eye and, in the case of a traumatic brain injury, the brain.
For this reason, patients with nasal injuries other than an otolaryngologist must be examined by an ophthalmologist and a neurologist.
Treatment. Fracture of the bones of the nose without displacement, usually within 7-14 days.
On the first day after the injury, a cold is applied to the fracture site; from the second day, the doctor may recommend physiotherapy procedures to relieve the swelling.
If due to a fracture, the bones of the nose have shifted, it is considered that it is necessary to restore the former shape of the nose within 10 days after the fracture. Doctors call this manipulation reposition. Delayed reposition can be made from 10 days to 1 month.
But in this case the intervention will be more traumatic and its result will not always satisfy the patient. Such manipulations are usually carried out under local anesthesia, but if you stay longer with the restoration of the shape of the nose for even longer, you will have to resort to complex reconstructive surgery.
It is always performed under general anesthesia.