Nose bleeds (Epistaxis)

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NOSE BLEEDS ( Epistaxis)

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WHAT IS EPISTAXIS?

Epistaxis is the medical term for a nose bleed. This can occur in one or both nostrils, it can appear frightening especially if the flow is quite heavy and lasts a while. Nosebleeds are often caused by an irritation, inflammation and damage of small blood vessels, which lie close to the surface inside the nose.

Other reasons why nose bleeds occur may include blowing the nose forcibly, picking the nose, trauma to the nose, recent surgery to the nose, a change in temperature (dry or cold air) or humidity can cause the insides of the nose to become dry and cracked, an infection in the lining of the nostrils, sinuses or adenoids, colds, flu or hay-fever, straining as a result of constipation or as a symptom of high blood pressure (Hypertension).

WHO GETS NOSE BLEEDS? 

Nose bleeds are fairly common, the nose has lots of blood vessels which lie close to the surface of the insides of the nostrils.

For some people this can occur as a one-off episode whilst others may get nose bleeds more regularly. Frequent or heavy nosebleeds should be investigated as they may indicate other health problems. Nose bleeds mostly affect;

 

  • Children between the ages of two to ten years

  • The elderly

  • Pregnant women

  • People taking certain medication such as anticoagulants (e.g. Warfarin, Aspirin or Rivaroxaban) or those using steroid nasal sprays to prevent/manage certain allergies or congestion.

  • People with clotting disorders, such as Haemophilia

  • Recurring colds or constant exposure to dry air

 

MANAGEMENT OF NOSE BLEEDS 

The initial treatment of nosebleeds is reliant on simple first aid however if the bleeding persists longer than 10-15 minutes, the patient has other medical problems or the flow is heavy then urgent medical treatment should be sought.

First aid management include;

  • Sitting upright whilst leaning forward a little with your mouth open, if feeling faint then lie flat on your side.

  • Apply light pressure on the nose by pinching the lower fleshy end of the nose using your index finger and thumb for about 10-15 minutes or if available use a nose pack, this can be uncomfortable

  • Apply a cold flannel or compress around the nose and the front of your face as the cold will help the blood vessels to constrict thereby reducing the flow of blood.

  • Once stopped do not pick or forcibly blow your nose as this could restart the bleeding.

 

Further management of nose bleeds may include;

  • The application of a cream/ointment into the nostrils to stop the blood flow.

  • Nasal Cautery- this is where a specific tool is used to seal the blood vessels thus stopping the bleeding.

PREVENTING NOSE BLEEDS

To prevent nosebleeds, it may be advisable to

  • Use a humidifier whilst sleeping especially if the air is dry.

  • Keep your nose moist by using a saline spray or an ointment such as Vaseline to protect the lining of the nose.

  • Stay hydrated by drinking enough fluids.