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Criteria for immediate referral

Authoring team

Refer patient to hospital immediately if symptoms suggest:

  • septal haematoma:
  • swelling of the septum seen on looking up the nose - untreated, leads to necrosis of cartilage, collapse of the bridge and saddle nose
  • other facial or skull fracture:
  • diplopia - blowout fracture of the orbit
  • limited extraocular movement (1)
  • numbness of cheek - fracture of the malar bone
  • malocclusion of teeth - fracture of the jaw
  • trismus (spasm of V) - motor disturbance of the trigeminal nerve
  • CSF rhinorrhoea - fracture of the temporal bone
  • anosmia - shearing of the olfactory nerves
  • subcutaneous emphysema (1)
  • mental status changes (1)

Reference:

(1) Corry J. Kucik. Management of acute nasal fractures.Am Fam Physician 2004;70:1315-20

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