Nose Treatment

EPISTAXIS

Epistaxis (nosebleed) is one of the most common ear, nose, and throat (ENT) emergencies that present to the emergency room or primary care.
There are two types of nosebleeds:
1) anterior (more common)
2) posterior (less common, but more likely to require medical attention).

Your nose has many tiny blood vessels in it. These vessels help warm and moisten the air you breathe. But they lie close to the inner surface of your nose. When air moves through your nose, it can dry and irritate your blood vessels. This makes them very easy to injure or break, causing a nosebleed.


Who gets epistaxis?

Anyone can get epistaxis. However, some people are more likely to have a nosebleed.
They include:

  • Children: Dry air, colds, allergies,  and sticking fingers and objects into their noses make children more prone to nosebleeds.
  • Adults between the ages of 45 and 80: Blood may take longer to clot in mid-life and in older adults. These adults are also more likely to have high blood pressure,  atherosclerosis  (hardening of the walls of arteries) or a bleeding disorder. 
  • Pregnant females: Blood vessels in your nose expand while you’re pregnant,  which puts more pressure on the delicate blood vessels in the lining of your nose.
  • People taking blood-thinning medications: These drugs include aspirin and warfarin.
  • People who have blood clotting disorders: These include hemophilia  and von Willebrand disease. 

How to stop a nosebleed?

Use the following steps to stop a nosebleed at home.

  • Sit upright and lean your body and your head slightly forward. Breathe through your mouth.
  • Use a tissue or damp washcloth to catch the blood.
  • Use your thumb and index finger to pinch together the soft part of your nose. Make sure to pinch the soft part of the nose against the hard bony ridge that forms the bridge of your nose.
  • Keep pinching your nose continuously for at least five minutes before checking if the bleeding has stopped. If your nose is still bleeding, continue squeezing your nose for another 10 minutes.
  • Apply an ice pack to the bridge of your nose to further help narrow blood vessels.
  • After the bleeding stops, don’t bend over, strain, and/or lift anything heavy. Don’t blow or rub your nose for several days.
Treatment-
  • Nasal packing: Your healthcare provider will insert gauze, special nasal sponges or foam, or an inflatable latex balloon into your nose to create pressure at the site of the bleed. Your provider may want to leave the material in place for 24 to 48 hours before removing it.
  • Cauterization: This procedure involves applying a chemical substance (silver nitrate) or heat energy (electrocautery)  to seal the bleeding blood vessel. Your provider will spray a local anesthetic in your nostril first to numb the inside of your nose.
  • Medication adjustments/new prescriptions: Reducing or stopping the amount of blood-thinning medications can be helpful. In addition, medications for controlling blood pressure may be necessary.
  • Surgery: Surgical repair of a broken nose or correction of a deviated septum (septoplasty)  if this is the cause of the nosebleed.
  • Ligation: In this procedure, your provider will tie off the culprit blood vessel to stop the bleeding.
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