Acute fractured nose

Scope

This guideline covers the primary care management of bilateral nasal obstruction for adults and children.

Red flags

  • Suspicion of septal haematoma

Refer via on call ENT consultant (RD&E switchboard 01392 411 611)

Management

Exclude septal haematoma
  • Re-assess 7-10 days post injury
  • Once swelling has subsided the need for manipulation under anaesthetic (MUA) can be assessed. MUA should be within 21 days
  • If a new external deformity is present - email urgent referral to: rde-tr.opasurgeryteam@nhs.net, clearly marking BROKEN NOSE in subject (do not send via e-Referrals as may delay definitive treatment)

Following an assessment with no evidence of a new external deformity the patient can be reviewed and managed in primary care.

Joint Formulary Chapter 12 ENT

Referral

Referral Criteria

GP assessment at 7 days post trauma

Referral Instructions

Same Day ENT assessment

Contact on call SHO (RD&E switchboard 01392 411 611)

Refer to ENT

Email referral to: rde-tr.opasurgeryteam@nhs.net, clearly marking BROKEN NOSE in subject (do not send via e-Referrals as may delay definitive treatment)

Supporting information

Patient Information

Nasal fracture patient leaflet

Evidence

This guideline has been developed by Royal Devon and Exeter Healthcare Foundation Trust based on local guidelines.

Pathway Group

This guideline has been signed off by the Northern Locality on behalf of NEW Devon CCG.

Publication date: November 2017

 

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