Emergency Medical Technician (EMT) Intermediate Practice Exam

What should you suspect if clear, watery fluid drains from a patient's nose following blunt head trauma?

1. Sinus injury

2. Fracture of the nasal bone

3. Damage to all of the meningeal layers

4. Facial soft tissue injury

The correct answer is: Damage to all of the meningeal layers

If clear, watery fluid drains from a patient's nose after blunt head trauma, the primary concern is that this fluid could be cerebrospinal fluid (CSF). The presence of CSF suggests that there may be a breach in the protective layers surrounding the brain, specifically the meningeal layers. Damage to these layers can occur with significant head trauma, especially if there is a fracture in the skull that leads to leakage of CSF. When CSF leaks from the nose, it is indicative of a more serious injury, such as a basilar skull fracture. This type of injury can compromise the meninges, leading to leaks of CSF and increasing the risk of central nervous system infections, such as meningitis. Although injuries to the sinus or nasal bone and facial soft tissue can occur with blunt trauma, they do not typically present with clear, watery fluid from the nose unless there is a more significant underlying meningeal damage. Recognizing the possibility of CSF leakage is crucial for prompt and appropriate medical intervention.