Nosebleeds- How to manage this common and often frightening symptom

Getting a nosebleed or seeing a child get one can be scary and dramatic, but most nosebleeds are nothing to worry about. Nosebleeds (whose medical term is “epistaxis”) are incredibly common. Almost everyone has had one in his or her lifetime. Dry air or nose picking usually causes them.

If you get a nosebleed or you see someone else with one, the important thing is to know how to manage it properly. With the right self-care and know how, most nosebleeds will stop on their own. This following article will outline how to manage nosebleeds as well letting you know the circumstances in which a nosebleed warrants immediate medical attention, explain proper self-care for a nosebleed, list the common causes of nosebleeds, and suggest some steps to help prevent recurrent nosebleeds.

In the world of nosebleeds there are two main types that we talk about and one can be much more serious than the other. The two types are posterior and anterior nosebleeds and they have the following characteristics:

Posterior nosebleeds come from the back of the nose, near the throat. They are less common than anterior nosebleeds, but they can be serious and can cause a lot of blood loss. Children do not usually get posterior nosebleeds.

Anterior nosebleeds come from the front of the nose and result in blood flowing through the nostrils. This tends to be the most common type and is very rarely serious.

Emergency care should be sought if you have a nosebleed that involves a large amount of bleeding and makes it hard for you to breathe, makes you pale, disoriented or really tired, occurs following surgery on the nose or if you have a known nasal tumour, will not stop even after the self cares that will be talked about below, or if it occurs with other serious symptoms like chest pain. Also if the nosebleed is the result of an injury in which you suspect other injuries may be present or if it will not stop bleeding and you are on medications that prevent blood clotting such as warfarin or daily aspirin.

If you are having symptoms such as chest pain, light-headedness, or if bleeding is extensive, you should call for emergency medical help. In the United States and Canada, this means calling 911. It is important that you do not drive yourself to the hospital and do not ask someone else to drive you. If you drive to the hospital, treatment cannot begin until you arrive in the emergency department and it is best for treatment to begin in the ambulance.

With the right self-care, most nosebleeds will stop on their own. The following provides a good step-by-step guide on how to manage if you or someone you know gets a nosebleed.

  1. Blow your nose. This will get rid of some of the clots that may have formed in your nose as a result of the bleeding. Bleeding may increase when you do this but it will be temporary and is nothing to worry about.
  2. Sit or stand while bending forward slightly at the waist. Do not lie down or tilt your head back. This may cause you to swallow blood and can lead to vomiting and other uncomfortable symptoms. Many people still think that it is good practice to tilt head back but this is NOT true and it is important to correct anyone who thinks so.
  3. Grip the soft part of BOTH nostrils at the bottom of your nose. Use your thumb and index fingers and do not grip the top part of your nose, as that will not help the bleeding, and do not apply pressure to just one side, even if the bleeding is only on one side.
  4. Squeeze your nose closed for at least 5 minutes (for children) or 10 to 15 minutes (for adults), ensure that you use a watch to time yourself so that you do not lose track, do not estimate that time. It is also important to not release the pressure at any point even to check if the bleeding has stopped. Many people ruin their chances of the bleeding stopping on its own by releasing the pressure too soon or too often.
  5. If you want, you can also apply an ice pack or cold compress to the bridge of your nose. This can help the blood vessels constrict and slow the bleeding. This step is not entirely necessary, but many people like to do it as it makes things more comfortable and may help the bleeding subside.

If you have followed all of the above steps and your nose does not stop bleeding then steps 1-5 must be followed again so that there is pressure on your nose for at least half an hour. If after this time the bleeding has not subsided then you must seek emergency medical care.

So what causes a nosebleed in the first place? Well inside the nose there are many blood vessels, which are very much close to the surface, and thus it is easy for them to get injured. Also the nose sticks out from your face and so it at risk of being damaged very easily. Most nosebleeds are literally caused by nothing more than irritation from one picking their nose, or from cold or dry air exposure.

Sometimes nosebleeds happen because of an injury to the face caused by a fall, a bike accident, or another type of trauma. Sometimes people get nosebleeds because they are suffering from allergies or a cold, and their nose has become raw and inflamed. Other times, only rarely do serious issues, such as bleeding disorders, blood vessel abnormalities, or cancer, cause nosebleeds.

If you take medications for other conditions that will stop you from producing blood clots then you are more likely to get a nosebleed and also it will be more difficult for you to stop that bleed. Examples of the medications that can cause these problems include: warfarin, clopidogrel, or daily aspirin. If you take one (or more) of these medications and you get frequent nosebleeds, mention it to your healthcare provider. In addition, nosebleeds can be a side effect of nose sprays used for allergy symptoms. If you get frequent nosebleeds, you may need to completely stop using the spray.

If you wind up needing medical care for a nosebleed, your healthcare provider will focus first on making sure you can breathe properly and on getting the bleeding to stop. If you have lost a lot of blood, you may need IV fluids to restore the lost blood.

If the bleeding will not stop and the doctor can see the source of the bleeding, he or she may stop the bleeding using a chemical or an electrical device. In severe cases, doctors can pack the nostrils with tampons, gauze, foam, or other materials that can help stop the bleeding. People with serious nosebleeds may need to have a balloon inflated deep within their nose to get the bleeding under control. The nose may also be checked for growths, blood vessel abnormalities or tumors. A growth or tumor may be more likely if only one nostril bleeds repeatedly or if the blood has an unpleasant smelling odour. Another explanation for one-sided bleeding or odorous discharge is the presence of a foreign body. When examining children with unexplained nosebleeds, healthcare providers often find beads, rubber erasers, and even green peas rammed deep inside the nose. It really is amazing what kids will put up their noses.

If you do get nosebleeds frequently, things that you may want to consider to reduce the chance of getting a nosebleed include; the use of a humidifier in your bedroom while sleeping, especially when the air is very dry, keeping your nose moist with saline nasal spray or gel and you must avoid picking your nose. But if you really can’t keep your finger out then consider clipping you nails to avoid injury.


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