Nose Bleed (Epistaxis)-First Aid

A nosebleed (epistaxis) is the relatively common occurrence of bleeding from the nose.

The bleeding may be profuse, or simply a minor complication. 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.

There are two types of nose bleed:

- Anterior (the most common), and

- posterior (less common, more severe).

Etiology

• Rupture of dilated blood vessels at the Little’s area, on the anterior part of nasal septum, rupture

• Inflammatory reaction (eg. acute respiratory tract infections, chronic sinusitis, allergic rhinitis)

• Foreign bodies

• Intranasal tumors (Nasopharyngeal carcinoma in adult, and juvenile angiofibroma in adolescent males)

• Trauma

• High Blood Pressure

• Drugs – aspirin, warfarin, cloplet etc

• Blood dyscrasias

• Hematological malignancy

• Hypertension

• Infectious diseases

• Vascular disorders

First Aid Measures

• Get the patient to sit down, lean slightly forward and pinch the fleshy part of the nose, and push against the bony parts of the face. They should breathe through their mouth, spitting out blood to avoid choking, and to aid assessment of control of blood loss.

• The pressure and posture should be maintained for at least 10 minutes but a longer time may be required.

• Ice packs to forehead may be applied

• First aid also includes inserting either a balloon inflated nasal tampon

• Uncontrollable epistaxis and posterior epistaxis should be referred to hospital.

Persistent epistaxis is an indication for urgent ENT consultation. Nasal packing, cryosurgery, electrocautery, laser cautery or application of silver nitrate are options that may be used in minor epistaxis. If a nosebleed lasts for more than 15 minutes, accompanied by severe blood loss, you should call your doctor or go to the emergency room.

(More on the treatment of Epistaxis, look for similar articles on this site)

Dr Paulose is an ENT Consultant Plastic and Laser Surgeon with over 35 years of experience covering in Ear, Nose and Throat procedures, specializing in Laser Surgery and conventional medicine across India, U.K. and Middle East. He is currently engaged with the Jubilee Hospital, in Kerala, India.