Nasal fracture: Difference between revisions
(Created page with "==Background== *Always assess for associated head, face, and neck injuries ==Clinical Features== *Nasal deformity, bony crepitus *Profuse epistaxis *Periorbital ecchymosis in th...") |
(nerve block link) |
||
Line 20: | Line 20: | ||
####Place lidocaine soaked cotton pledgets for 5min | ####Place lidocaine soaked cotton pledgets for 5min | ||
####Inject local anesthetic | ####Inject local anesthetic | ||
####Perform | ####Perform [[Nerve Block: Infraorbial]] and [[Nerve Block: supraorbital]] if needed | ||
###Reduction | ###Reduction | ||
####Insert elevator until contact is made with the depressed nasal bone | ####Insert elevator until contact is made with the depressed nasal bone |
Revision as of 21:52, 31 December 2013
Background
- Always assess for associated head, face, and neck injuries
Clinical Features
- Nasal deformity, bony crepitus
- Profuse epistaxis
- Periorbital ecchymosis in the absence of other findings of orbital injury
Diagnosis
- Clinical diagnosis (imaging rarely needed)
Treatment
- Exclude other associated traumatic injuries
- Treat septal hematoma
- Immediately incise and drain
- Most nasal fractures do not require immediate intervention
- Can be managed by outpt ENT within 6-10d
- Consider ED reduction only if pt presents before significant swelling has occurred
- Anesthesia
- Place lidocaine soaked cotton pledgets for 5min
- Inject local anesthetic
- Perform Nerve Block: Infraorbial and Nerve Block: supraorbital if needed
- Reduction
- Insert elevator until contact is made with the depressed nasal bone
- Lift depressed nasal bone anteriorly and laterally in one fluid motion
- Use external splinting and/or nasal packing to maintain alignment
- Anesthesia
Disposition
- Refer to ENT within 6-10d regardless of whether perform reduction or not
Source
Tintinalli