Nasal Bleeding (Epistaxis)

What should be done in case of bleeding from the nose?

Bleeding from the nose is a problem that can cause fear. In fact, most bleeding from the nose is not as serious a problem as it might seem.

However, caution should be taken because a proportion of these cases are related to more serious illnesses and so required vigilance to identify the cause of the problem.

If someone is bleeding from the nose or ‘epitaxis’ as is medically termed, they should sit down and lean the head slightly forward.

The head should be kept at a level higher than the heart, because it will bleed less. The slight inclination of the head towards the front, allows blood to be discharged out of the nostrils and not back to the pharynx.

The head should not be tilted backward as the blood then goes back down the pharynx and the patient swallows. This can causes nausea, vomiting and diarrhea.

To assist the bleeding to stop, the patient can pinch lightly between thumb and forefinger, the area of ​​the nose that is between the hard part of the nose (nasal bone) and soft part below.

For best results, tightness should be maintained for at least 5-10 minutes. Usually after 10 minutes, ‘epistaxis’ stops. If it continues, then hold again for another 10 minutes.

Also the positioning of cold ice in the same area of ​​the nose helps to stop bleeding.

What causes bleeding from the nose?

The nose has many blood vessels which help to heat and moisten the air we breathe. Because they are closer to the surface of the nasal mucosa is more vulnerable to injury and cause bleeding.

The most common cause of bleeding from the nose is sore inside of nose.

In areas without heating and dehumidified air, the mucosa of the nose can become dry and cause bleeding.

Scratching the nose with fingers, especially nails can cause bleeding. In the front part of the nose, particularly the diaphragm, there are many vessels.

Most cases of bleeding occur in children due to dryness of the internal mucosa of the nose, in rhinitis and scratching of the nose with the fingers.

In children a foreign body inserted into the nose of the nostrils as well as various injuries, can cause bleeding.

In adults, injuries, infections of the nose, allergies, high blood pressure, arteriosclerosis, bleeding diathesis, anticoagulant medications, aspirin, drought and low humidity are causes of epistaxis.

When the patient must visit the doctor?

In some cases, such as those mentioned below, it may be necessary for the patient to visit the doctor:

• When bleeding lasts for more than 15 minutes

• When bleeding is caused by an injury (blow to the face), after a car accident or after a fall.

• Where the nose bleeds often

• In the case of bleeding from the rear part of the nose. These cases are rare and usually occur in the elderly, the bleeding is from large vessels of the posterior part of the nose. These hemorrhages are serious and need medical treatment necessary.

In the elderly, high blood pressure, atherosclerosis, bleeding is likely either due to disease or medication such as aspirin, and can cause severe posterior nosebleeds. The doctor will clarify whether it is anterior or posterior bleeding. We also investigate whether there is another disease or generalized or local body responsible for causing the bleeding.

The specialist doctor, otolaryngologist, can use various methods to stop the bleeding, which include suction cleaning, the fitting of cotton impregnated with vasoconstrictive substance, the cauterization of bleeding vessels, tamponade (patted). Rarely, you may need surgery to stop nosebleeds.