Health education 03: Epistaxis/Nose bleeding

hafiz34 (66)in #health-status • 6 years ago (edited)

Nose bleeding which is in medical language known as epistaxis is quite common as well as frightening symptom among general population. In most of the cases nose bleeding is a minor symptom and bleeding stops with minimal effort. But sometimes its severity may impose threat to the victim’s life.

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Why does nose bleed?

Nose can bleed due to local or general causes:
Local causes are:

Idiopathic: Means exact reason can’t be found out
Trauma or injury to the nasal passage by foreign body or nasal fracture or nose-picking
Following nasal surgery or application of intranasal steroid medications may lead to epistaxis
Bleeding from the nose may be the feature of nasal, paranasal and nasopharyngeal tumors

General causes are:

Some medications may contribute in bleeding from nose. Such as anticoagulants (warfarin) and antiplatelet agents (aspirin)
Severe hypertension
Coagulation disorder: where blood fails to clot due to deficiency of some of the components required for coagulation
Osler-Weber-Rendu syndrome: It is a familial condition i.e. if parents have such condition, children may have too.

As I mentioned earlier, the bleeding may be a minor incidence and no need to be panicked. Simple first aid at home is in most of cases sufficient enough to stop the bleeding. However, to find out the cause, a patient should visit a doctor. Immediate first aid steps are:

Applying digital pressure on the lower part (soft part) of the external nose
Putting ice pack on the nose
Leaning forward
Asking the patient to avoid swallowing any blood running backward of his/her nose, as this may cause nausea/vomiting

If the bleeding is not stopped, continue following the above steps and go to the emergency department. If bleeding occurs in recurrent fashion, you also should visit emergency department where surgical procedures will be done to stop the bleeding. If the bleeding is profuse, resuscitation in the form of intravenous access, fluid replacement or blood transfusion, and oxygen can be administered. Following steps can be taken to stop epistaxis, surgically:

Cautery with a silver nitrate sticks done under local anesthesia
Intranasal cautery of the bleeding vessel
Insertion of intranasal packing
(If above treatment fail) Surgical ligation of the sphenopalatine artery can be undertaken endoscopically. An interventional arterial embolization can be performed for the problematic vessel

A picture of nasal pack in situ

Bleeding point inside of the nose:

There is an area known as Little’s area on the front part of nasal septum (each side) where 4 blood vessels meet. This is the most vulnerable place for injury due to nose picking or any other kinds of trauma.