Fractured Nose


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

Red Flags

Bilateral Nasal Obstruction – see same day via on call ENT consultant


Exclude septal haematoma:

  • Assess 7-10 days post injury
  • Allow examination once swelling has subsided/need for MUA can be assessed. MUA should be within 21 days
  • Assess if a new external deformity has developed within 7 days of injury - send for same day ENT referral
  • History of acute nasal trauma
  • Check if there is a new unilateral nasal obstruction

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

Patients who may need a referral:

  • Patients with new external deformity should be referred for a same day ENT assessment
  • Patient with new unilateral nasal obstruction should be referred for ENT referral via e-Referral

Joint Formulary - Ear, nose and oropharynx


Referral Criteria

GP assessment at 7 days post trauma

Same day ENT assessment:

Contact on Call Registrar (Derriford Hospital switchboard 01752 202082

Referral Instructions

e-Referral Service Selection

  • Specialty: ENT
  • Clinic: Nose/Sinus
  • Service: DRSS-Western-ENT- Devon CCG-15N

Referral Forms

DRSS referral form

Supporting Information

Pathway Group

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

Publication date: March 2016


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