Nosebleed
Most
nose bleeds are associated with minor injuries to the nose or with common colds
Simple first aid steps should stop the
bleeding in 5–15 minutes
Sometimes a nosebleed has a serious
underlying cause
Most nosebleeds occur more frequently
in winter
The
common nosebleed is easy to stop without medical attention
Alternative names
epistaxis; bleeding from the nose
What is
a nosebleed?
A nosebleed is usually due to the rupture of small vessels overlying
the anterior (front) part of the nasal septum - the cartilage that separates the
two sides of the nose - (nasal chambers), which contains many fragile blood
vessels that are easily damaged.
What
causes a nosebleed?
A minor nosebleed is often caused by a blow to the nose or from
vigorous nose blowing, nose picking, irritation from a foreign body lodged in
the nose (common in small children), hay fever; repeated sneezing, upper
respiratory infection or facial and nasal surgery.
Sometimes nosebleeds have serious underlying causes. Arteriosclerosis is a
possible cause in the elderly. Polyps and other fleshy growths in the nose, food
allergies, hypertension, vitamin deficiencies or any disease producing a
bleeding tendency may cause a nosebleed.
Bleeding
from the nose that does not originate in the nose itself is a serious indication
that some damage has been done internally, either by injury or disease. Medical
attention is necessary to trace the bleeding to its source. The blood probably
originates in the stomach, the lungs, within the skull, or in passages related
to these parts.
Who gets
nosebleeds and who is at risk?
Nosebleeds occur more frequently in winter when viruses are common
and heated indoor air dries out the nostrils.
Symptoms
and signs of nosebleed
Sudden bleeding from one or both nostrils.
How is
nosebleed diagnosed?
In most cases a nosebleed is easily stopped and there is no need for
further investigation. However, if the bleeding is difficult to stop or occurs
frequently, a visit to your doctor is necessary. Your doctor will obtain a
history from you and perform a physical examination with a special instrument to
look inside your nose to check exactly where the problem lies.
Medical
history questions documenting nosebleeds may include:
How
much bleeding is there?
When did the nosebleeds begin?
Do they occur frequently or
repeatedly?
What other symptoms are present?
Is
there blood in your faeces or are you vomiting blood?
Diagnostic tests that may be performed include:
Complete blood count
Partial thromboplastin time
measurements
Prothrombin
(PT)
X-rays
of the skull
Can
nosebleeds be prevented?
If you often have nosebleeds, there are certain measures you can take
to decrease their frequency. Applying petroleum jelly to the inside of your
nostrils once or twice a day can help. A cooler house and a humidifier or
vaporizer (which returns humidity to the air) may also help to decrease
nosebleeds. In addition, avoid picking your nose and do not blow your nose for
several hours after a nosebleed.
How is a
nosebleed treated?
The common nosebleed is easy to stop by using the following steps:
Sit
up or stand. Do not lie down. An upright position slows the flow of blood.
Squeeze the soft portion of the nose
between the thumb and index finger for 5-10 minutes, while breathing through
your mouth. This should stop the flow of blood.
If a
nosebleed persists your doctor may treat it by using several steps. First,
excess blood is removed with a suction device. A medical cotton ball is then
placed in the nose. The medication anaesthetises and shrinks the nasal membrane.
If the bleeding still persists, your doctor may recommend chemical or electrical
cautery. If the bleeding persists after cautery, your doctor may gently pack
your nose with medicated gauze.
Nosebleeds caused by an underlying disease such as hypertension or
arteriosclerosis, or that occur far back in the nose, are more difficult to
stop. Your doctor will probably seek the help of a specialist who will place a
special pack in your nasal cavity. This procedure will be performed in hospital.
A 2-3 day stay will be necessary for observation.
When to
call the doctor
When a nosebleed occurs after an
injury to the head, which may indicate a skull fracture (X-rays should be taken
no matter how trivial the blow seems at the time.)
When there are repeated nosebleeds,
particularly if they are becoming more frequent and are not associated with a
cold or other minor irritation.
