During a Krav Maga self defence drill a middle aged martial arts enthusiast cleverly blocked a full contact punch with his nose. Following a suggestion to pause training to control the bleeding, he noticed some lateral nasal displacement which was easily manually reduced with an audible click. He was able to resume training with a piece of toilet paper stuffed up the bleeding nostril, and no ill effects were noticed on subsequent training nights that week.
The day after injury he demonstrated a characteristic bruising pattern:
As he was working an aeromedical retrieval shift, he was able to use the Retrieval Service Sonosite M-Turbo ultrasound machine to identify the cortical disruption from his nasal bone fracture.
Ultrasound compares favourably with both plain radiography(1) and computed tomography(2) in the diagnosis of nasal bone fractures.
Personal access to sonography and full board certification in emergency medicine help to decrease health care costs and emergency department load when individuals sustain fractures that do not require operative management(3).
1. Comparison of ultrasonography and conventional radiography in the diagnosis of nasal fractures.
Arch Otolaryngol Head Neck Surg. 2005 May;131(5):434-9
2. Comparison of high-resolution ultrasonography and computed tomography in the diagnosis of nasal fractures.
J Ultrasound Med. 2009 Jun;28(6):717-23
3. Only when I laugh
When the same bloke broke his rib