Disease: Nosebleed
(Epistaxis, Nose Bleed, Bloody Nose)

    Nosebleed facts

    • Nosebleeds are common due to the location of the nose on the face, and the large amount of blood vessels in the nose.
    • The most common causes of nosebleeds are drying of the nasal membranes and nose picking (digital trauma), which can be prevented with proper lubrication of the nasal passages and not picking the nose.
    • Most nosebleeds can be stopped at home.
    • Consult a doctor for a nosebleed if bleeding cannot be stopped, there is a large amount of blood lost, or you feel weak or faint.
    • A doctor may use nasal packs to stop nosebleeds when conservative measures fail.
    • Do not take aspirin or other blood thinning products when you get a nosebleed (if they are doctor-prescribed, consult your doctor before stopping any medication).

    What causes nosebleeds?

    The nose is a part of the body rich in blood vessels (vascular) and is situated in a vulnerable position  protruding on the face. As a result, trauma to the face can cause nasal injury and bleeding. The bleeding may be profuse, or simply a minor complication. Nosebleeds can occur spontaneously when the nasal membranes dry out and crack. This is common in dry climates, or during the winter months when the air is dry and warm from household heaters. People are more susceptible to a bloody nose if they take medications that prevent normal blood clotting (warfarin [Coumadin], aspirin, or any anti-inflammatory medication). In this situation, even a minor trauma could result in significant bleeding.

    Learn more about: Coumadin

    The incidence of nosebleeds is higher during the colder winter months when upper respiratory infections are more frequent, and the temperature and humidity fluctuate more dramatically. In addition, changes from a bitter cold outside environment to a warm, dry, heated home result in drying and changes in the nose which make it more susceptible to bleeding. Nosebleeds also occur in hot dry climates with low humidity, or when there is a change in the seasons. The following factors predispose people to nosebleeds:

    • Infection
    • Trauma, including self-induced by nose picking, especially in children
    • Allergic and non-allergic rhinitis
    • Hypertension (high blood pressure)
    • Use of blood thinning medications
    • Alcohol abuse
    • Less common causes include tumors and inherited bleeding problems
    • Hormonal changes during pregnancy may increase the risk of nosebleeds.

    How do you stop the common nosebleed?

    Most people who develop nose bleeding can handle the problem without the need of a physician if they follow the step-by-step first aid recommendations below:

    1. Pinch all the soft parts of the nose together between the thumb and index finger.
    2. Press firmly toward the face - compressing the pinched parts of the nose against the bones of the face.
    3. Lean forward slightly with the head tilted forward. Leaning back or tilting the head back allows the blood to run back into the sinuses and throat and can cause gagging or inhaling the blood.
    4. Hold the nose for at least five minutes. Repeat as necessary until the nose has stopped bleeding.
    5. Sit quietly, keeping the head higher than the level of the heart. Do not lay flat or put your head between your legs.
    6. Apply ice (wrapped in a towel) to nose and cheeks.

    How do you prevent the nose from bleeding again?

    1. Go home and rest with head elevated at 30 to 45 degrees.
    2. Do not blow your nose or put anything into it. If you have to sneeze, open your mouth so that the air will escape out the mouth and not through the nose.
    3. Do not strain during bowel movements. Use a stool softener (for example, docusate [Colace]).
    4. Do not strain or bend down to lift anything heavy.
    5. Try to keep your head higher than the level of your heart.
    6. Do not smoke.
    7. Stay a cool diet of soft, cool foods and beverages. No hot liquids for at least 24 hours.
    8. Do not take any medications that will thin the blood for example, aspirin, ibuprofen, clopidogrel bisulfate (Plavix) or warfarin (Coumadin). Do not stop taking any medications without first contacting your doctor.
    9. Your doctor may recommend some form of lubricating ointment for the inside of the nose.
    10. If re-bleeding occurs, try to clear the nose of clots by sniffing in forcefully. A temporary remedy such as a nasal decongestant spray, for example, Afrin or Neo-Synephrine may be helpful. These types of sprays constrict blood vessels. (NOTE: If used for many days at a time, these can cause addiction so they are recommended for short-term use only. Do not use if the patient has high blood pressure.)
    11. Repeat the steps above on how to stop the common nosebleed. If bleeding persists, call the doctor and/or go to the nearest emergency department.

    What precautions can you take to prevent nose bleeding?

    Learn more about: Plavix | Neo-Synephrine

    The most common cause of a nose bleeds is drying of the nasal membranes. If a person is prone to recurrent nosebleeds, it is often helpful to lubricate the nose with an ointment of some type. The ointment can be applied gently with a Q-tip or fingertip up inside the nose, especially on the middle portion (the septum). Many people use remedies for nosebleeds such as A + D ointment, methylsalicylate/menthol (Mentholatum, BenGay, Icy Hot), Polysporin, neomycin/bacitracin/polymyxin (Neosporin ointment), or Vaseline. Saline mist nasal spray is often helpful (Ocean Spray).

    When should you call your doctor or go to an emergency room?

    • If bleeding cannot be stopped or keeps occurring.
    • If bleeding is rapid, or if blood loss is large.
    • If you feel weak or faint.
    • If your nosebleed is associated with trauma to the face, loss of consciousness, or blurry vision.
    • If your nosebleed is associated with a fever or headache.
    • If your infant or baby has a nosebleed, contact the pediatrician.

    If the nosebleed persists or is recurrent, see your doctor, who may recommend stopping the nosebleed with a heating instrument or chemical swab (cautery of the blood vessel that is causing the trouble) or application of a topical medicine called thrombin that promotes local clotting of blood. Blood tests may be ordered to check for bleeding disorders. If bleeding is still persistent, the doctor may place nasal packs, which compress the vessels and stop the bleeding. In rare situations, you may be admitted to the hospital or require surgical treatment or a procedure where material is used to plug up the bleeding vessels in the nose (angiographic embolization).

    Learn more about: thrombin

    What causes nosebleeds?

    The nose is a part of the body rich in blood vessels (vascular) and is situated in a vulnerable position  protruding on the face. As a result, trauma to the face can cause nasal injury and bleeding. The bleeding may be profuse, or simply a minor complication. Nosebleeds can occur spontaneously when the nasal membranes dry out and crack. This is common in dry climates, or during the winter months when the air is dry and warm from household heaters. People are more susceptible to a bloody nose if they take medications that prevent normal blood clotting (warfarin [Coumadin], aspirin, or any anti-inflammatory medication). In this situation, even a minor trauma could result in significant bleeding.

    Learn more about: Coumadin

    The incidence of nosebleeds is higher during the colder winter months when upper respiratory infections are more frequent, and the temperature and humidity fluctuate more dramatically. In addition, changes from a bitter cold outside environment to a warm, dry, heated home result in drying and changes in the nose which make it more susceptible to bleeding. Nosebleeds also occur in hot dry climates with low humidity, or when there is a change in the seasons. The following factors predispose people to nosebleeds:

    • Infection
    • Trauma, including self-induced by nose picking, especially in children
    • Allergic and non-allergic rhinitis
    • Hypertension (high blood pressure)
    • Use of blood thinning medications
    • Alcohol abuse
    • Less common causes include tumors and inherited bleeding problems
    • Hormonal changes during pregnancy may increase the risk of nosebleeds.

    What precautions can you take to prevent nose bleeding?

    Learn more about: Plavix | Neo-Synephrine

    The most common cause of a nose bleeds is drying of the nasal membranes. If a person is prone to recurrent nosebleeds, it is often helpful to lubricate the nose with an ointment of some type. The ointment can be applied gently with a Q-tip or fingertip up inside the nose, especially on the middle portion (the septum). Many people use remedies for nosebleeds such as A + D ointment, methylsalicylate/menthol (Mentholatum, BenGay, Icy Hot), Polysporin, neomycin/bacitracin/polymyxin (Neosporin ointment), or Vaseline. Saline mist nasal spray is often helpful (Ocean Spray).

    When should you call your doctor or go to an emergency room?

    • If bleeding cannot be stopped or keeps occurring.
    • If bleeding is rapid, or if blood loss is large.
    • If you feel weak or faint.
    • If your nosebleed is associated with trauma to the face, loss of consciousness, or blurry vision.
    • If your nosebleed is associated with a fever or headache.
    • If your infant or baby has a nosebleed, contact the pediatrician.

    If the nosebleed persists or is recurrent, see your doctor, who may recommend stopping the nosebleed with a heating instrument or chemical swab (cautery of the blood vessel that is causing the trouble) or application of a topical medicine called thrombin that promotes local clotting of blood. Blood tests may be ordered to check for bleeding disorders. If bleeding is still persistent, the doctor may place nasal packs, which compress the vessels and stop the bleeding. In rare situations, you may be admitted to the hospital or require surgical treatment or a procedure where material is used to plug up the bleeding vessels in the nose (angiographic embolization).

    Learn more about: thrombin

    Source: http://www.rxlist.com

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