How To Stop Nosebleeds

Bleeding from the front of the nose is quite a common occurrence and is easy to control either by simple home measures or by a general practitioner. It is a common ENT emergency which can be scary and frightening. Luckily, most often it is not serious and usually can be managed, although sometimes, medical intervention may become necessary.

While bleeding from the front of the nose is called anterior epistaxis, the other form of nose bleeding is from the back and deeper end of the nose. called posterior epistaxis, which is less common and tends to occur ¡n the elderly. This ¡s more complicated and usually needs admission into a hospital and should be managed by an ENT specialist.

Causes

The commonest cause for nose bleeding is trauma to the nose either external, such as a blow to the tace, or internal, due to nose picking. However, in most cases there is no easily identifiable cause. Some other local conditions that can cause epistaxis includes prolonged exposure to warm and dry air, sino-nasal infections, allergies, foreign body inside the nose. blowing the nose hard, nasal surgeries and septal deviation or perforation, to name a few.

Some of the less common causes of nose bleeding include drugs or medications such as anti-platelets that prolong blood clotting, which include aspirin, ecospirin. clopidogrel, NSAI Ds (non-steroidal anti-inflammatory drugs). Sometimes nasal bleeding may also be caused by topical nasal medications like antihistamines and corticosteroids.

Chronic liver or kidney disease, long standing alcohol abuse, platelet disorders and inherited bleeding disorders can interfere with blood clotting and influence nasal bleeding. Vascular malformations inside the nose and certain tumours of the nose are some rare causes of epistaxis Uncontrolled hypertension can also cause nose bleeds, but often it is the anxiety associated with nose bleeding that leads to an increase in the BP.

Nose bleeding in the paediatric age group or children between two to twelve years is common and is at most times, harmless and self-limiting. It can also normally be managed at home. And unlike adults, bleeding in children occurs from the front of the nose. It is a spontaneous occurrence, even though some children may experience it more frequently.

The most common causes of nose bleeding in children are minor trauma due to nose picking and exposure to warm, dry air leading to crusting. especially during the summer.

The commonest causes for nose bleeding is trauma to the nose, either external such as a blow to the face, or internal, due to nose picking

Dealing With Nosebleeds Not a lot needs to be done when there is only a small amount of bleeding from the nose. For example, if a person with sinusitis or a cold blows his/her nose forcefully and notices blood on the tissue, they should avoid vigorous nose sneezing, blowing the nose and nose picking. This ¡s enough to keep the bleeding from getting worse.

When To Seek Medical Intervention

If bleeding persists after pinching the nose for 10 to 20 minutes.
If nosebleeds occur frequently over a short time or if a large amount of blood is lost.
If feeling dizzy or lightheaded
Heart beat is fast or there is trouble with breathing.
If vomiting blood
Have a rash or high fever

Treatment

Most of the anterior bleeding is controlled by day care office procedures such as chemical cauterization (sealing the blood vessel). In severe cases it may be necessary to pack the nose with medicated gauze, balloon nasal packs and synthetic sponge packs that expand when moistened.

The decision on the best course of treatment is made by the ENT specialist. The packing is left in place for 48 to 72 hours. If this does not control bleeding, then arterial embolization or certain surgical procedures may be required.

Prevention

Avoid nose picking and forceful blowing of the nose.
Trim children’s nails
Use saline drops or moisturizers during summer.
Take blood thinners only under medical supervision
Keep blood pressure under control

FirstAid

Don’t get anxious and panicky
Sit straight with the head raised. Leaning your head forward while tilting your head back will only make you swallow blood.
Pinch the nostrils together and apply direct pressure with the thumb and index finger for 10 minutes.
Apply ice packs tightly over the nose on both sides.
Spit out any blood in the mouth. Swallowing blood may make one feel nauseous.