Facial Injuries
Topic Overview At one time or another, everyone has had a minor facial injury that
caused pain, swelling, or bruising. Home treatment is
usually all that is needed for mild bumps or bruises. Causes of facial injuriesFacial injuries most
commonly occur during: - Sports or recreational activities, such as ice
hockey, basketball, rugby, soccer, or martial arts.
- Work-related
tasks or projects around the home.
- Motor vehicle crashes.
- Falls.
- Fights.
In children, most facial injuries occur during sports or
play or are caused by falls. Minor facial injuries in young children
tend to be less severe than similar facial injuries that occur in older
children or adults. Young children are less likely to break a facial bone
because they have fat pads that cushion their faces and their bones are more
flexible. But young children are more likely to be bitten in the face by
an animal. Head injuries may occur at the same time as a facial
injury, so be sure to check for
symptoms of a head injury. For more information, see
the topic
Head Injuries, Age 3 and Younger or
Head Injuries, Age 4 and Older. Types of injuriesFacial injuries may be caused by a
direct blow, penetrating injury, or fall. Pain may be sudden and severe.
Bruising and swelling may develop soon after the injury. Acute injuries
include: - A
cut or puncture to your face or inside your mouth. This often occurs with
even a minor injury. But a cut or puncture is likely to occur when a jaw
or facial bone is broken. The bone may come through the skin or poke into the
mouth.
- Bruises from a tear or rupture of small blood vessels
under the skin.
- Broken bones, such as a fractured cheekbone.
- A dislocated jaw, which may occur when the lower
jawbone (mandible) is pulled apart from one or both of the joints connecting it
to the base of the skull at the temporomandibular (TM) joints. This can cause
problems even if the jaw pops back into place.
TreatmentTreatment for a facial injury may include
first aid measures, medicine, and in some cases surgery. Treatment depends
on: - The location, type, and severity of the
injury.
- How long ago the injury occurred.
- Your age,
health condition, and other activities, such as work, sports, or hobbies.
When you have had a facial injury, it is important to
look for signs of other injuries, such as a
spinal injury,
eye injury, or an injury to the mouth, such as a cut
lip or injured tooth. Check your symptoms to decide
if and when you should see a doctor. Check Your SymptomsHave you had an injury to your face in the past 2 weeks? Yes Facial injury in the past 2 weeks No Facial injury in the past 2 weeks How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Do you have an eye injury? Did you injure your nose? Did you pass out completely (lose consciousness)? If you are answering for someone else: Is the person unconscious now? (If you are answering this question for yourself, say no.) Are you back to your normal level of alertness? After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do. Yes Has returned to normal after loss of consciousness No Has returned to normal after loss of consciousness Did the loss of consciousness occur during the past 24 hours? Yes Loss of consciousness in past 24 hours No Loss of consciousness in past 24 hours Do you have symptoms of shock? Are you having trouble breathing (more than a stuffy nose)? Yes Difficulty breathing more than a stuffy nose No Difficulty breathing more than a stuffy nose Would you describe the breathing problem as severe, moderate, or mild? Severe Severe difficulty breathing Moderate Moderate difficulty breathing Mild Mild difficulty breathing Do you think there could be a spinal cord injury? Yes Possible spinal cord injury No Possible spinal cord injury Is the wound bleeding? If you think the wound may need stitches, it's best to get them within 8 hours of the injury. Have you had any new vision changes? These could include vision loss, double vision, or new trouble seeing clearly. Did you have a sudden loss of vision? A loss of vision means that you cannot see out of the eye or out of some part of the eye. The vision in that area is gone. Do you still have vision loss? Yes Vision loss still present No Vision loss still present Did the vision loss occur within the past day? Yes Vision loss occurred in the past day No Vision loss occurred in the past day Have you had double vision? Are you seeing double now? Yes Double vision now present No Double vision now present Did the double vision occur within the past day? Yes Double vision occurred in the past day No Double vision occurred in the past day Are you having trouble seeing? This means you are having new problems reading ordinary print or seeing things at a distance. Is it hard to swallow or talk? Yes Trouble swallowing or talking No Trouble swallowing or talking Does one side of your face sag or droop? Yes One side of face sags or droops No One side of face sags or droops Do you think that the injury may have been caused by abuse? Yes Injury may have been caused by abuse No Injury may have been caused by abuse Is there any numbness or tingling in your face? Yes Facial numbness or tingling No Facial numbness or tingling Does your face have a cut or puncture wound? Yes Cut or puncture wound on face No Cut or puncture wound on face Can you see bone, pieces of bone, or any objects in the wound? Yes Bones, bone fragments, or objects in wound No Bones, bone fragments, or objects in wound Is the cut or wound more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with sides that gape open? Wounds like this often need stitches. If you need stitches, it's best to get them within 8 hours of the injury. Yes Cut more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with sides that gape open No Cut more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with sides that gape open Are you worried about scarring? Yes Worried about scarring Do you think you may have a broken jaw? If your jaw is broken, your top and bottom teeth may not fit together the way they did, or some of your teeth may be loose. Yes Possible broken jawbone No Possible broken jawbone Is your jaw locked? This means that you can't close it. Do you have any pain in your face? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Do you think you may have a fever? Are there red streaks leading away from the area or pus draining from it? Do you have diabetes, a weakened immune system, or any surgical hardware in the area? "Hardware" in the facial area includes things like cochlear implants or any plates under the skin, such as those used if the bones in the face are broken. Yes Diabetes, immune problems, or surgical hardware in affected area No Diabetes, immune problems, or surgical hardware in affected area Is there any swelling or bruising? Does the cheekbone, nose, or eye socket look different than it did before the injury? For example, the nose or cheekbone might look crooked or out of place, and the eye socket may not be the same shape it was before. Yes Cheekbone, nose, or eye socket looks misshapen No Cheekbone, nose, or eye socket looks misshapen Yes Symptoms of skull fracture No Symptoms of skull fracture Is there any bruising under the tongue? Have your symptoms lasted longer than 1 week? Yes Symptoms have lasted longer than 1 week No Symptoms have lasted longer than 1 week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury. Symptoms of shock (most of which will be present) include: - Passing out (losing consciousness).
- Feeling very dizzy or
lightheaded, like you may pass out.
- Feeling very weak or having
trouble standing.
- Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury. Symptoms of shock in a child may include: - Passing out (losing consciousness).
- Being very sleepy or hard
to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused.
The child may not know where he or she is.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. - Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
You may need a tetanus shot depending
on how dirty the wound is and how long it has been since your last shot. - For a dirty wound that has
things like dirt, saliva, or feces in it, you may need a shot if:
- You haven't had a tetanus shot in the past 5
years.
- You don't know when your last shot was.
- For a clean wound, you may
need a shot if:
- You have not had a tetanus shot in the past 10
years.
- You don't know when your last shot was.
Symptoms of infection may
include: - Increased pain, swelling, warmth, or redness in or
around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Symptoms of a spinal cord injury in an
adult or older child may include: - Severe neck or back pain.
- Not being
able to move a part of the body. (This is not the same as being unable to move
because of pain or because of a direct injury to that
area.)
- Weakness, tingling, or numbness in the arms or
legs.
- New loss of bowel or bladder control.
With severe bleeding, any of these may
be true: - Blood is pumping from the wound.
- The
bleeding does not stop or slow down with pressure.
- Blood is quickly soaking through bandage after bandage.
With moderate bleeding, any of these may
be true: - The bleeding slows or stops with pressure but
starts again if you remove the pressure.
- The blood may soak through
a few bandages, but it is not fast or out of control.
With mild bleeding, any of these may be
true: - The bleeding stops on its own or with
pressure.
- The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Some types of facial wounds are more likely to leave a scar than others. These include: - Jagged wounds on the face.
- Cuts on the eyelids.
- Cuts to the lips, especially if they cut through the edge of the lip.
Stitches or other treatment may help prevent scarring. It's best to get treated within 8 hours of the injury. Symptoms of a skull fracture may
include: - Clear or bloody fluid draining from the ears or
nose.
- Bruising under the eyes or behind the
ears.
- Drooping of the face.
- A dent anywhere on the head.
Symptoms of difficulty breathing can range from mild to severe. For example: - You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Severe trouble breathing means:
- You cannot talk at all.
- You have to
work very hard to breathe.
- You feel like you can't get enough
air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means: - It's hard to talk in full
sentences.
- It's hard to breathe with activity.
Mild trouble breathing means: - You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Severe trouble breathing means: - The child cannot eat or talk because he or she is
breathing so hard.
- The child's nostrils are flaring and the belly
is moving in and out with every breath.
- The child seems to be
tiring out.
- The child seems very sleepy or confused.
Moderate trouble breathing means: - The child is breathing a lot faster than
usual.
- The child has to take breaks from eating or talking to
breathe.
- The nostrils flare or the belly moves in and out at times
when the child breathes.
Mild trouble breathing means: - The child is breathing a little faster than usual.
- The child seems a little out of breath but can still eat or talk.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Do not move the person unless there is an immediate threat to the person's life, such as
a fire. If you have to move the person, keep the head and neck supported and in
a straight line at all times. If the person has had a diving accident and is
still in the water, float the person face up in the water. Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can. Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Eye Injuries Nose Injuries Home TreatmentHome treatment may help treat
problems and prevent complications after an injury to your face. First aid for bleedingFacial injuries can bleed a lot even if they are minor injuries. Stop any bleeding from the nose, mouth, or face so you can see what the injury is. Crying
increases blood flow to the face and can make a nosebleed or facial bleeding
worse. If your injured child is crying, speak in a quiet, relaxed manner to
soothe him or her. First aid for a suspected broken bone- Do not move misshapen facial bones. It may make an injury worse, increase bleeding, or cause more
problems.
- Apply an
ice or cold pack immediately to prevent or minimize
swelling.
- Seek medical evaluation and treatment.
Measures to reduce pain, swelling, and bruising- Use ice. Cold will reduce pain and swelling.
Apply an
ice or cold pack immediately to prevent or minimize swelling. Apply the ice
or cold pack for 10 to 20 minutes, 3 or more times a day. After 48 to 72 hours,
if swelling is gone, apply
warmth to the area that hurts.
- Keep your
head elevated, even while you sleep. This will help reduce
swelling.
- For the first 48 hours, avoid things that might increase
swelling, such as hot showers, hot tubs or hot packs, or drinking alcohol or
hot fluids.
- Do not take aspirin or other nonsteroidal
anti-inflammatory drugs (NSAIDs) for the first 24 hours. Aspirin prolongs the
clotting time of blood and may cause more nose or facial
bleeding.
- Eat soft foods and cold foods and fluids to reduce jaw
and mouth pain. Avoid hot foods or beverages, which may increase swelling
around the mouth.
Do not smoke. Smoking slows healing because it decreases
blood supply and delays tissue repair. For more information, see the topic
Quitting Smoking. Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
---|
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following symptoms occur during
home treatment: - Numbness or tingling
develop.
- Changes in vision develop, such as double
vision or blurring.
- Signs of infection
develop.
- Pain and swelling continue or get worse.
- Symptoms become more severe or frequent.
PreventionThere are many steps you can take to help
prevent a facial injury. - Always use car safety seats and seat belts to
prevent or reduce nose and facial injuries during a car crash.
- Do not use alcohol or other drugs
before participating in sports or when operating a motor vehicle or other
equipment.
- Wear a helmet and other protective clothing whenever
you are biking, motorcycling, skating, skateboarding, kayaking, horseback
riding, skiing, snowboarding, or rock climbing. Make sure your children also wear helmets and protective clothing to prevent sports injuries.
- Wear a mouth
protector when you participate in contact sports.
- Wear a hard hat
if you work in an industrial area.
- Wear safety glasses, goggles,
or face shields when you work with power tools or when you do an activity that
might cause an object to fly into your face.
- Do not dive into
shallow or unfamiliar water.
- Prevent falls in your home by
removing hazards that might cause a fall.
- Do not keep
guns in your home. If you must keep
guns, lock them up and store them unloaded and uncocked.
Lock ammunition in a separate area.
You can take steps to help reduce your young child's risk of
facial injury. - Never leave your child unattended in a high
place, such as on a tabletop; in a crib with the sides down; on elevated
porches, decks, or landings; or even on a bed or sofa.
- Do not
leave your child alone in any infant seat or sitting toy, such as a swing or
jumper. Use all of the safety straps provided.
- Use stair gates to
block stairways. Use gates at the top and bottom of the stairs, and use the
gates properly.
- Do not use baby walkers. Baby walkers have caused
many injuries and are not safe even if the baby is watched
closely.
- Watch your child when he or she is outside. Uneven grass,
sloping lawns, and hills may be hard for your child to walk
on.
- When your toddler is using a bottle or sippy cup, have him or her stay seated. This can help prevent injuries that might occur if your child were to fall while walking and holding a bottle or a cup.
- Make your home safe from falls by removing hazards that might
cause a fall, such as throw rugs.
- Place your child in an approved
child car seat when traveling in a car. Follow the manufacturer's directions
for securing the seat in the car. Children should ride in the back seat for
safety.
- Have your children wear helmets when necessary, such as
when they are passengers on a bike or are riding a tricycle or bicycle on their
own.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to
answer the following questions: - When did your injury occur?
- What
caused your injury?
- What are your main symptoms?
- What
have you done so far to treat your injury?
- Have you had a facial
injury in the past?
- Was your injury evaluated by a doctor?
- What was the diagnosis?
- How was your
injury treated?
- Do you have any continuing problems because of the
previous injury?
- Was this injury from abuse caused by another
person?
- Was the use of alcohol or drugs involved in your
injury?
- What home treatment measures have you tried? Did they
help?
- What prescription or nonprescription medicines do you
take?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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