Nose Injury (Nosebleed or Broken Nose)
Content reviewed against published AAP, ENT Health, Red Cross guidelines
Last reviewed:
Nose injuries in children range from simple nosebleeds to fractures. Most nosebleeds from trauma stop with proper first aid. A broken nose needs medical evaluation but is rarely a surgical emergency in children.
Immediate actions
- May not require 911 — see guidance below
- Keep child calm and sitting upright, leaning slightly forward
- DO NOT: Do NOT tilt the head back — this causes blood to flow down the throat
Step-by-Step Response
Position the child
Sit the child upright and lean them slightly forward. This prevents blood from going down the throat and causing nausea or choking.
Pinch the nose
Using your thumb and index finger, pinch the soft, fleshy part of the nose (below the bony bridge) firmly. Maintain constant pressure for a full 10-15 minutes. Do NOT release to check.
Apply cold
Place a cold compress or ice pack wrapped in a cloth on the bridge of the nose. This helps constrict blood vessels.
After 15 minutes, release
Gently release pressure and check if bleeding has stopped. If still bleeding, reapply pressure for another 15 minutes.
Assess for fracture
After bleeding stops, look for: visible deformity, significant swelling, bruising around both eyes, clear fluid from nose, or inability to breathe through the nose.
Determine care level
Go to ER for: uncontrolled bleeding, suspected fracture with deformity, clear fluid leaking from nose (possible CSF), or associated head injury. Doctor visit within 3-5 days for: swelling with suspected break but no deformity.
What NOT to Do
- ✕Do NOT tilt the head back — this causes blood to flow down the throat
- ✕Do NOT have the child lie down during a nosebleed
- ✕Do NOT stuff tissue or cotton into the nose
- ✕Do NOT let the child blow their nose for several hours after bleeding stops
- ✕Do NOT try to straighten a nose that appears crooked — let a doctor evaluate
- ✕Do NOT pick at clots forming in the nose
When to Seek Help
Call 911 if:
- Heavy nosebleed that will not stop after 20+ minutes of direct pressure
- Nose injury with loss of consciousness or suspected head/neck injury
- Clear, watery fluid draining from the nose after head trauma (possible cerebrospinal fluid leak)
- Difficulty breathing through both nostrils with significant facial swelling
- Nosebleed with signs of significant blood loss (dizziness, paleness, rapid heartbeat)
Go to ER if:
- Nosebleed that will not stop after 20 minutes of correct pressure
- Visible deformity of the nose
- Bruising under both eyes after nose impact
- Significant breathing difficulty through the nose after injury
- Nose injury with suspected septal hematoma (one-sided swelling inside the nose)
- Clear fluid from nose after any head trauma
Call your doctor if:
- Nosebleed that stopped but child gets frequent recurrent nosebleeds
- Mild swelling of the nose without obvious deformity
- Nosebleed in a child on blood-thinning medication
- Nose injury healing check after 3-5 days when swelling has reduced
Age-Specific Guidance
0-2 years
Nosebleeds from trauma are less common at this age but can occur from falls when learning to walk. Any significant facial injury in a non-mobile infant warrants investigation.
2-5 years
Nose-picking is the most common cause of nosebleeds. Trauma from falls and collisions with other children is frequent. Teach proper pinch technique to caregivers.
5-12 years
Sports-related nose injuries become more common. Dry-air nosebleeds are frequent. Teach children proper first aid (sit up, lean forward, pinch). Broken noses should be evaluated within 7-10 days.
Prevention
- Ensure children wear face guards for contact sports
- Teach children not to pick their nose — this causes most non-traumatic nosebleeds
- Use a humidifier in dry climates to prevent nasal dryness and cracking
- Apply petroleum jelly inside nostrils if child gets frequent dry-air nosebleeds
- Supervise active play to prevent face-to-face collisions
- Install padding on sharp corners at face height for small children
Frequently asked questions
Should I call 911 for nose injury (nosebleed or broken nose)?
What should I do first?
What should I NOT do?
How can I prevent this?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Emergency Guides
Bottom line
Stay calm and follow the steps above. When in doubt, call your pediatrician or go to the nearest emergency room.
You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.