NOSEBLEED

(Epistaxis)

 Basic information

description

A nosebleed is sudden bleeding from one or both nostrils. The bleeding involves blood vessels (arteries and veins) in the nose. Nosebleeds may occur close to the nose opening or deeper in the nose. They can affect all ages, but are twice as common in children as in adults.

FREQUENT SIGNS & SYMPTOMS

• Blood oozing from the nostril. If the broken vessel is close to the nostril, the blood is bright red. If the broken vessel is deeper in the nose, the blood may be bright or dark red.
• Lightheadedness from a large amount of blood loss (rare).
• Rapid heartbeat, shortness of breath, and pallor (with significant blood loss only).
• Black stool from swallowed blood.

causes

Injury to the nose, breathing dry air, allergies, illnesses, or for no apparent reason.

risk increases with

• Injury to the nose.
• Nasal or sinus infection.
• A foreign body in the nose.
• Dry mucous membranes in the nose from any cause, such as low humidity.
• Bleeding tendencies associated with some illnesses.
• Allergic rhinitis (hay fever) or nonallergic rhinitis.
• Use of certain drugs, such as anticoagulants, aspirin, or prolonged use of nose drops.
• Exposure to irritating chemicals.
• Excess alcohol use.
• High altitude or dry climate.

PREVENTIVE MEASURES

• Avoid injury if possible.
• Get medical treatment for sinus or allergy problems.
• Humidify the air if you live in a dry climate or at high altitude.
• Avoid picking at nose or vigorous nose blowing.
• Avoid aspirin if you have frequent nosebleeds.

expected outcomes

Most nosebleeds are harmless, even though it seems like a lot of blood is lost. They are usually controlled with self-care by applying pressure to the nose.

possible complications

Bleeding may rarely be severe and require medical care.

 diagnosis & treatment

general measures

Self-care:

• Sit up with your head bent forward.
• Clamp your nose closed with your fingers for 10 full minutes. During this time, breathe through your mouth. Holding your nose tightly closed allows the blood to clot and seal the damaged blood vessels.
• If bleeding stops and recurs, repeat, but pinch your nose firmly on both sides for 8 to 10 minutes.
• You may apply cold compresses or an ice pack at the same time you are applying pressure.
• Don't blow your nose for several hours after bleeding stops to avoid dislodging the blood clot.
• Don't swallow blood. It may upset your stomach or make you "gag," causing you to inhale blood.
• Don't talk (also to avoid gagging).

Medical care:

• Seek emergency treatment if self-care is not successful. Gauze packing may be inserted to absorb blood, stop the dripping, and exert pressure on the ruptured blood vessels. Ongoing bleeding may require cauterization (use of heat to seal off blood vessels).
• Surgery (for severe bleeding only) to tie off the artery feeding the bleeding area.

medications

Drugs are not needed for a nosebleed. They may be prescribed to treat an underlying disorder.

activity

Resume your normal activities as soon as symptoms improve.

diet

No special diet.

 notify our office if

• You or a family member has a nosebleed that won't stop with self-care steps.
• After the nosebleed, you become nauseous or vomit, or your temperature rises to 101°F (38.3°C) or higher.

Special Notes: