Epistaxis By Jessica Davies

What is Epistaxis? Epistaxis more commonly known as a Nose Bleed 2 types: Anterior (front of the nose) Posterior (back of the nose)

Anterior Nose Bleeds Make up more than 90% of all nosebleeds Bleeding usually comes from a blood vessel at very front part of the nose Usually easy to control, either by measures that can be performed at home or by a doctor.

Posterior Nose Bleeds Much less common than anterior nosebleeds Tend to occur more often in elderly people Bleeding usually comes from an artery in the back part of the nose These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

What causes it? Most Common Reasons(Trauma): Blow to the face Picking your nose Constant irritation for a cold Least Common Reasons(Underlying Disease): Unable to create blood clots(i.e. Liver disease) Abnormal blood vessels Cancer High Blood Pressure

Symptoms Usually bleeding occurs from only one nostril If bleeding is heavy it can bleed from both and even over flow into stomach Signs of excessive blood loss include dizziness, light-headedness, confusion, and fainting Excessive blood loss from nosebleeds does not often occur.

Treatment To stop a nosebleed: Remain calm. Sit up straight. Lean your head forward. Tilting your head back will only cause you to swallow the blood. Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier. Spit out any blood in your mouth. Swallowing it may make you vomit.

Treatment continued… After the bleeding has stopped: Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours. Ice packs do not help. Exposure to dry air, such as in a heated home in the winter, can contribute to the problem. Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.

When is it serious? When to call the doctor about nosebleeds: If you have repeated episodes of nosebleeds If you have additional bleeding from places other than the nose, such as in the urine or stool If you bruise easily If you are on any blood-thinning drugs, including aspirin or warfarin (Coumadin) If you have any underlying disease that may affect your blood clotting, such as liver disease, kidney disease, or hemophilia (inability of blood to clot) If you recently had chemotherapy

When is it serious? Go to the hospital for nosebleeds if: You are still bleeding after pinching the nose for 10 minutes. You are having repeated episodes of nosebleeds over a short time. You feel dizzy or light-headed or like you are going to pass out. You have a rapid heartbeat or trouble breathing. You are coughing up or vomiting blood. You have a rash or temperature greater than than 101.4°F (38.5°C). Your doctor instructs you to go to a hospital's emergency department.

Prevention Most nosebleeds occur during the winter in cold, dry climates. If prone to nosebleeds use: Humidifier in your home Petroleum jelly (Vaseline) Over-the-counter nasal lubricant spray Saline nasal spray to keep your nasal passages moist. Avoid picking your nose or blowing your nose too vigorously. If the nosebleed is related to another medical condition, such as liver disease or a chronic sinus condition, follow your doctor’s instructions to keep that problem under control. Stop smoking. Smoking contributes to nasal dryness and irritation.