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Epistaxis(Nosebleeding): Causes and Treatment

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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 the nose) or posterior (back of the nose).\n

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epistaxis nosebleeding

EPISTAXIS (NOSEBLEEDING)

Symptoms | Causes | Treatment

introduction to epistaxis
Introduction to Epistaxis
  • Bleeding from nostril, nasal cavity or nasopharynx is called Epistaxis (Nosebleeding).
  • Most often self limited, but can often be serious and life threatening.
  • 5-10% of the population experience an episode of epistaxis each year, 10% of those will seek a physician and 1% of those will need a specialist.
  • Fairly common, is seen in all age groups.
causes of epistaxis
Causes of Epistaxis
  • Excessive nose blowing and picking
  • Injury to the nose or face
  • Dry, warm air, commonly found indoors during the winter
  • Inserting foreign object into the nose
  • High blood pressure
  • Deviated septum
  • Facial and nasal surgery
  • Tumors
  • Bleeding disorders
  • Use of certain medication and drugs
symptoms of epistaxis
Symptoms of Epistaxis
  • Signs of excessive blood loss include dizziness, light-headedness, confusion, and fainting.
  • Additional bleeding from other parts of the body, such as bleeding gums when brushing teeth, blood in urine or stool, or easy bruising may indicate an inability of the blood to clot.
daignosis of epistaxis
Daignosis of Epistaxis

Laboratory investigations are not usually necessary, although they may be required in certain specific circumstances

  • Haematocrit or FBC is obtained if there is a concern about anemia from excessive blood loss or clotting abnormality
  • Coagulation studies are required in the presence of atypical persistence, recurrence, or recalcitrance to treatment.
  • Urea, serum creatinine, and LFTs are usually only performed if there is a concern about the patient’s general medical condition.
treatment of epistaxis
Treatment of Epistaxis

If you are bleeding from the front of your nose, begin by trying the following first-aid measures:

  • Sit up (so your head is above the level of your heart), lean forward slightly and breathe through your mouth.
  • With your thumb and index finger, pinch the entire front of your nose (just above your nostrils and below the hard, bony base) and hold for five minutes.
  • At the same time, use your other hand to apply an ice pack or a plastic bag of crushed ice to the bridge of your nose to slow blood flow.
  • After you have pinched your nose for five minutes, release it to see if your nose is still bleeding. Keep the ice pack on for another 10 to 15 minutes.
countinue treatment of epistaxis
Countinue: Treatment of Epistaxis
  • If your nose is still bleeding, pinch it for an additional 10 minutes.
  • Release your nose again. If you are still bleeding, seek emergency medical help

When simple first aid does not stop a nosebleed, your doctor may treat the problem by:

  • Applying medication directly to the inside of your nose to stop the bleeding
  • Sealing off (cauterising) the injured blood vessel with a chemical, such as silver nitrate, or with an electric probe
  • Packing your nose with gauze or a sponge
prevention of epistaxis
Prevention of Epistaxis
  • Most nosebleeds occurs during the winter in cold, dry climate. If one is prone to nosebleeds, he/she should use a humidifier in his home. We should use petroleum jelly (Vaseline), over the counter nasal lubricant spray, or a saline nasal spray to keep nasal passage moist.
  • Avoid picking the nose or blowing the nose to vigorously.
  • Do not strain when bending or lift anything too heavy
  • Stop smoking. Smoking contributes to nasal dryness and irritation.
  • If the nosebleed related to other medical conditions, such as liver disease or a chronic sinus condition occurs, follow doctor’s instruction to keep that problem under control.
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