What should you always inspect nose wounds for?

What should you always inspect nose wounds for?

• A. Nasal fracture
• B. Infection
• C. Septal hematoma (drain + PCN, cephalosporin, macrolide)
• D. Foreign body

Answer: (C)

In nasal injury care, the crucial finding to assess for is a septal hematoma. The septal cartilage relies on the overlying mucosa and tiny vessels for its blood supply, so a collection of blood between the mucosa and cartilage can compress and cut off perfusion. If not drained urgently, the cartilage can become necrotic, leading to a permanent deformity (saddle nose). Look for a fluctuant, swollen area on the nasal septum, often with nasal obstruction or tenderness. If you find this, it warrants immediate incision and drainage in the event room or operating room, followed by antibiotics to prevent infection. Antibiotic coverage is given after drainage to reduce infection risk. Common choices include penicillin (or a penicillin-class drug), a cephalosporin, or a macrolide if penicillin allergy is present. The goal is to prevent infection of the hematoma and the underlying cartilage. Other nasal injuries like fractures, infection, or foreign bodies can occur, but the most time-critical issue to identify and treat is a septal hematoma because of its risk to cartilage viability.

In nasal injury care, the crucial finding to assess for is a septal hematoma. The septal cartilage relies on the overlying mucosa and tiny vessels for its blood supply, so a collection of blood between the mucosa and cartilage can compress and cut off perfusion. If not drained urgently, the cartilage can become necrotic, leading to a permanent deformity (saddle nose).

Look for a fluctuant, swollen area on the nasal septum, often with nasal obstruction or tenderness. If you find this, it warrants immediate incision and drainage in the event room or operating room, followed by antibiotics to prevent infection.

Antibiotic coverage is given after drainage to reduce infection risk. Common choices include penicillin (or a penicillin-class drug), a cephalosporin, or a macrolide if penicillin allergy is present. The goal is to prevent infection of the hematoma and the underlying cartilage.

Other nasal injuries like fractures, infection, or foreign bodies can occur, but the most time-critical issue to identify and treat is a septal hematoma because of its risk to cartilage viability.