Nose Bleeds/Epistaxis

Nose- bleeds/Epistaxis

60% of the general population has had at least one episode of a bleeding nose. Nose-bleeds can occur at any age but are most common in children aged 2 to 10 years and adults aged 50 to 80 years. 

 

Nosebleeds can be dramatic and frightening. Luckily, most nosebleeds are not serious and can be handled fairly easily. They are divided into two types, depending on whether the bleeding is coming from the anterior (front of thenose) or posterior (back) of the nose.

Anterior nosebleeds make up more than 90% of all nosebleeds. The bleeding usually comes from a blood vessel at the very front part of the nose. Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a doctor.
Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually comes from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

Causes 

• Allergic rhinitis
• An object stuck in the nose
• Barotrauma
• Blowing the nose very hard
• Chemical irritants
• Direct injury to nose, including a broken nose
• Hereditary hemorrhagic telangiectasia
• Nose picking
• Overuse of decongestant nasal sprays
• Repeated sneezing
• Surgery on the face or nose
• Taking large doses of aspirin or blood-thinning medicine
• Upper respiratory infection
• Very cold or very dry airRepeated nosebleeds may be a symptom of another disease such as high blood pressure, allergies, a bleeding disorder, or a tumor of the nose or sinuses.

Treatment

Home treatment for Nosebleeds 
A small amount of bleeding from a nosebleed requires little intervention. 

To stop a nosebleed:

• Remain calm.
• Sit up straight.
• Lean your head forward. Tilting your head back will only cause you to swallow the blood.
• Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier.
• Spit out any blood in your mouth. Swallowing it may make you vomit.

After the bleeding has stopped

Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours.
Ice packs may help.
Exposure to dry air, such as in a heated home in the winter, can contribute to the problem.
Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.
If the bleeding does not stop then medical intervention is required by an ENT surgeon, as nasal packing or cauterization may be required in order to stop the bleeding.

Seek medical care immediately if:

• The bleeding lasts for more than 20 minutes
• The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose