Nosebleeding

EPISTAXIS
• Nosebleeds (also known as epistaxis) are common, especially in children
• They are usually caused by minor trauma such as nose picking or forceful blowing of your nose
• Nosebleeds generally are treatable and are hardly ever serious
• They can be life threatening, particularly in the elderly, especially in those taking blood thinning drugs or people with blood disorders
What are the symptoms of epistaxis?
Nose bleeding can be classified as anterior or posterior bleeding
ANTERIOR NOSEBLEEDS
• Bleeding coming from the lower part of the nasal septum(wall between the 2 nostrils)
• Usually caused by minor trauma to that area
POSTERIOR NOSEBLEEDS
• Bleeding is heavy, coming from the back and higher up the nose, and goes down your throat
• Posterior nosebleeds are common in adults
What causes epistaxis
Nosebleeding can be caused by local or systemic factors

Local causes of nosebleeding include:
Trauma
Nosepicking, rigorous nose blowing, nasal fracture, foreign bodies, drugs
Inflammatory disease
Upper respiratory tract infection, allergic rhinitis, sinusitis
Tumors/congenital malformations
• Vascular tumors
• Nasopharyngeal cancer
Systemic causes of nosebleeding include:
• Hypertension
• Use of Anti-coagulant drugs - Aspirin, Coumadin, Heparin, NSAIDs
• Problems with structure of blood vessels
• Problems in blood clotting - Liver & kidney disease
- Chronic alcohol consumption
- Blood disorders
• Heart conditions - Congestive heart failure, heart valve problems
What are the diagnostic tests/procedures??
• Nosebleeds can be managed conservatively, or surgically if the need arises
What are the First Aid measures?
• If you are having a nosebleed, you should: - Lean forward and apply pressure by pinching your nose, just above the nostrils, for about 10-15 minutes
- Place ice chips inside the mouth
• If the bleeding does not stop despite the measures stated earlier, patient must be taken to the hospital
What are the treatment options to stop nose bleeding?
- Nasal endoscopy is done in order to search for the source of bleeding
- Nasal packing is sometimes necessary to stop the bleeding
Other treatment options include:
• Cauterization of blood vessels – a technique where you burn the blood vessel using laser or silver nitrate
• Arterial embolization
• Surgery(ligation of blood vessels)
Tips to prevent a nosebleed
• Keep the lining of the nose moist by applying a coat of petroleum jelly or an antibiotic ointment with a cotton swab 3 times daily.
• In children, keep fingernails short to discourage nose picking
• Counteract the effects of dry air by using a humidifier
• Use a nasal saline spray to moisten dry nasal membranes
• Quit smoking since it dries out the nose and irritates it
How can The Medical City help you?
At The Medical City we have a complete roster of competent otolaryngologists/ENT specialists who may assess or treat people with different types of nose bleeding.
For further inquiries or if you want to seek consult, please call:

EAR, NOSE & THROAT CENTER
Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6251

CENTER FOR PATIENT PARTNERSHIP
Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6444
References:
Cummings Otorhinolaryngology Volume 2
https://cks.library.nhs.uk/patient_information_leaflet/nosebleed
American Academy of Otolaryngology – Head & Neck Surgery
www.entnet.org
TMC Ear, Nose & Throat, Head & Neck Center
Note: This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment. If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.