Facial Trauma Assessment: Injuries to the Nose and Face

The examination looks for wounds, deformity, tenderness, nasal obstruction and signs that may suggest injury beyond the nose. Imaging or referral to another specialist may be needed depending on the location and severity of the injury.

Treatment depends on the injury and timing. Some injuries need observation and symptom care; others need repair or coordinated management. Do not try to straighten the nose yourself, and tell the clinician about blood-thinning medicines or previous facial surgery.

Information to provide

• When and how the injury happened
• Any loss of consciousness, vision change or difficulty moving the jaw
• Nosebleed, new obstruction, deformity or clear fluid from the nose
• Current medicines and previous nasal or facial procedures

What an assessment needs to establish

Facial injuries can involve more than the visible bruise or cut. An assessment considers how the injury happened, the force and direction of impact, bleeding, wounds, facial shape, nasal airflow, vision, jaw movement, teeth and possible head or neck injury. The examination is guided by symptoms and the structures that may have been affected.

Depending on the injury, care may involve wound assessment, examination of the nose and facial bones, imaging or coordination with emergency, eye, dental, maxillofacial or other specialist teams. Imaging is selected when it is likely to change management; it is not automatically needed for every minor injury.

Symptoms that should not wait for a routine appointment

• Bleeding that is heavy or will not stop with appropriate first aid
• New visual loss, double vision, severe eye pain or difficulty moving the eye
• Loss of consciousness, confusion, repeated vomiting or a severe head injury
• Difficulty breathing, a major open wound or rapidly increasing facial swelling
• Clear watery fluid from the nose after significant head trauma
• A painful or soft swelling inside the nose with new blockage, which may indicate a septal haematoma

These symptoms require urgent or emergency assessment. Do not use a routine online appointment request as a substitute for emergency care. If you are concerned about a serious head, eye or facial injury, attend an emergency department or contact emergency services.

How treatment is decided

The plan depends on which structures are injured, whether function is affected, the amount of swelling and the timing of the injury. Some injuries need cleaning, wound closure and observation. Others need specialist repair or a procedure after the initial swelling has been assessed. Nasal injuries may need a separate review for fracture or septal injury.

Do not attempt to push a displaced bone or reshape the nose yourself. Avoid applying pressure to an injured area and follow the advice given after examination. If symptoms change—especially vision, breathing, bleeding, alertness or pain—seek reassessment rather than waiting for a planned follow-up.

What to bring to the appointment

• The date, time and circumstances of the injury
• A list of symptoms immediately after the injury and how they have changed
• Details of any loss of consciousness, visual symptoms, bleeding or breathing difficulty
• Current medicines, especially blood thinners, and relevant allergies
• Details of previous facial or nasal surgery and any available photographs or reports

Related assessment

An injury centred on the nose may also need a focused nasal fracture assessment. Persistent bleeding or obstruction can require a different examination, depending on the findings.

Further patient information

• NHS: Broken Nose—Urgent Symptoms and Treatment
• NHS Greater Glasgow and Clyde: Nasal Fracture and Septal Haematoma

This information is general and does not replace an individual medical assessment.