Most nosebleeds can be stopped without the need for medical attention, but occasionally further treatment may be required.
What to do
To stop a nosebleed:
sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10-15 minutes
lean forward and breathe through your mouth – this will drain blood into your nose instead of down the back of your throat
place an ice pack or bag of frozen vegetables covered by a towel on the bridge of your nose
stay upright, rather than lying down as this reduces the blood pressure in the blood vessels of your nose and will discourage further bleeding
If the bleeding eventually stops, you won't usually need to seek medical advice. However, you should still follow the recovery advice outlined below.
When to seek medical advice
Contact your GP or call the NHS 111 service if:
you're taking a blood-thinning medicine (anticoagulant) such as warfarin or have a clotting disorder such as haemophilia and the bleeding doesn't stop
you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion
a child under two years of age has a nosebleed (this is rare and there's a chance it's caused by something serious)
you have nosebleeds that come and go regularly
Ask someone to drive you to your nearest accident and emergency (A&E) department or call 999 for an ambulance if:
the bleeding continues for longer than 20 minutes
the bleeding is heavy and you've lost a lot of blood
you're having difficulty breathing
you swallow a large amount of blood that makes you vomit
the nosebleed developed after a serious injury, such as a car crash
Find your nearest A&E department
If you see your GP or go to hospital with a nosebleed, you will be assessed to determine how serious your condition is and what's likely to have caused it. This may involve looking inside your nose, measuring your pulse and blood pressure, carrying out blood tests and asking about any other symptoms you have.
The main treatments that your GP or hospital doctor may use to stop your nose bleeding are described below.
Your doctor may prescribe an antibiotic ointment. This should be applied by squeezing a pea-sized amount onto the front of the nasal septum (wall between the nostrils).
This can reduce the inflammation and crusting in the nose and reduce the severity and frequency of nosebleeds.
Antibiotic ointment is particularly effective in children.
If your doctor is able to identify exactly where the bleeding is coming from, they may carry out a minor procedure to seal the bleeding blood vessel by cauterising (burning) it.
This is normally done using a stick of a chemical called silver nitrate. A local anaesthetic will be sprayed into your nose to numb it and the silver nitrate stick will be held against the bleeding point for up to 10 seconds.
If cautery is ineffective or your doctor is unable to identify a specific bleeding point, they may recommend packing your nose with gauze or special nasal sponges to stop the flow of blood by applying pressure to the source of the bleeding.
Packing will usually be carried out after local anaesthetic has been sprayed into your nose. The gauze or sponges often need to be left in place for 24-48 hours before being removed by a health professional. You'll usually need to be admitted to hospital to be monitored during this time.
If the treatments above don't help, you may be referred to a hospital specialist such as an ear, nose and throat (ENT) doctor for further treatment.
Additional treatments that may be used in hospital include:
electrocautery – an electric current running through a wire is used to cauterise the blood vessel where the bleeding is coming from
blood transfusions – a procedure to replace the blood you've lost
tranexamic acid – medication that can reduce bleeding by helping your blood to clot
packing under anaesthetic – your nose is carefully packed with gauze while you are unconscious from general anaesthetic
ligation – an operation using small instruments to tie off bleeding blood vessels in the back of your nose
Once your nose has stopped bleeding, you should follow the advice below to reduce the risk of your nose bleeding again and to stop you picking up an infection:
avoid blowing or picking your nose, heavy lifting, strenuous exercise, lying flat, and drinking alcohol or hot drinks for 24 hours
don't remove any crusts that form inside your nose – these may be unpleasant, but they're a useful part of the healing process
if you need to sneeze, try to sneeze with your mouth open to reduce the pressure in your nose
avoid people with coughs and colds
If you see a GP or a hospital doctor about your nosebleed, they may give you a prescription for an antiseptic nasal cream once the bleeding stops. This should be applied to the inside of your nostrils several times a day for up to two weeks to help prevent further bleeding.
If your nose does start to bleed again, follow the first aid advice above and seek medical advice if the bleeding doesn't stop.
Nosebleed Causes and Treatments - familydoctor.org
What are nosebleeds?
A nosebleed is blood loss from the tissue that lines your nose. It can affect both nostrils, but most often occurs in only one nostril. Usually, a nosebleed is not serious.
The nose has many blood vessels in it to help warm and humidify the air you breathe. These vessels lie close to the surface, making them easy to injure — which can cause a nosebleed. Sometimes, though, nosebleeds are more serious. These stem from large vessels in the back of the nose. Nosebleeds from these larger vessels often occur after an injury, in young children, or in the elderly. Usually, the older the patient, the more serious the nosebleed.
Symptoms of nosebleeds
Most often, you will have no other symptoms other than the nosebleed itself.
Most common nose bleed causes
Two of the most common causes of nosebleeds are dryness (often caused by indoor heat in the winter) and nose picking. These 2 things work together — nose picking occurs more often when mucus in the nose is dry and crusty. Colds also can cause nosebleeds.
Less common causes include injuries, allergies, or the use of illegal drugs, such as cocaine. Children may stick small objects up their noses, and that can cause the nose to bleed. Older people may have atherosclerosis (which is the hardening of the arteries), infections, high blood pressure, or blood clotting disorders that may cause nosebleeds. Nosebleeds may occur and last longer if you’re taking drugs that interfere with blood clotting, such as aspirin. A rare cause of frequent nosebleeds is a disorder called hereditary hemorrhagic telangiectasia (HHT). Sometimes, the cause of nosebleeds can’t be determined.
Frequent nosebleeds may mean you have a more serious problem. For example, nosebleeds and bruising can be early signs of leukemia. Nosebleeds can also be a sign of a blood clotting or blood vessel disorder, or a nasal tumor (both non-cancerous and cancerous).
How are nosebleeds diagnosed?
There is usually no need to formally diagnose a nosebleed. If your nose is bleeding, it’s fairly self-evident.
Can nosebleeds be prevented or avoided?
Tips for preventing nosebleeds:
Keep children’s fingernails short to limit nose injury and to discourage nose picking.
Counteract the drying effects of indoor heated air by using a humidifier at night in your bedroom.
Quit smoking. Smoking dries out your nose and also irritates it.
Open your mouth when you sneeze.
A nosebleed can be scary to get — or see — but try to stay calm. Most nosebleeds look much worse than they really are. Almost all nosebleeds can be treated at home.
If you get a nosebleed, sit down and lean slightly forward. Keeping your head above your heart will slow the bleeding. Lean forward so the blood will drain out of your nose instead of down the back of your throat. If you lean back, you may swallow the blood. This can irritate your stomach.
Use your thumb and index finger to squeeze together the soft portion of your nose. This area is located between the end of your nose and the hard, bony ridge that forms the bridge of your nose. Keep holding your nose until the bleeding stops. Don’t let go for at least 5 minutes. If it’s still bleeding, hold it again for another 5 to 10 minutes.
Once the bleeding stops, wait a few hours before doing anything that might make it start again, such as bending over or blowing your nose.
See your doctor if:
The bleeding goes on for more than 20 minutes.
The bleeding was caused by an injury, such as a fall or something hitting your face. In some cases, this may be a sign of internal bleeding.
The amount of blood makes it hard to breathe.
A child under 2 has a nosebleed.
You’re taking a blood thinning medicine.
You get nosebleeds weekly.
Your doctor will try to find out where the bleeding is coming from in your nose. He or she will probably ask you some questions and examine your nose. If the bleeding doesn’t stop on its own or when pressure is applied, your doctor may cauterize the bleeding vessel or pack your nose to stop the bleeding. Cauterization involves using a special solution called silver nitrate or an electrical or heating device to burn the vessel so that it stops bleeding. Your doctor will numb your nose before the procedure. Packing the nose involves putting special gauze or an inflatable latex balloon into the nose so that enough pressure is placed on the vessel to make it stop bleeding
Living with nosebleeds
Nosebleeds can be a nuisance. They come on suddenly, often with no warning. They usually aren’t harmful.
Questions for your doctor
I get a lot of nosebleeds. What can I do to stop them?
How long should I wait to call the doctor if I’m having a nosebleed?
I’m around secondhand smoke a lot. Could that be causing my nosebleeds?
Are nosebleeds more common in winter?
What can I do to prevent my child from picking his/her nose?
Could my nosebleeds be a sign of something more serious?
Should I avoid or hold off on any of my regular prescription medicines or over-the-counter medicines?
National Institutes of Health, MedlinePlus: Nosebleed
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Nosebleeds - symptoms, causes, risk factors, diagnosis and treatment in medical centers "K + 31
" The term "nosebleeds" refers to the leakage of blood from the nasal cavity. In eighty percent, it occurs at the Kisselbach point (anteroinferior cartilaginous section of the septum). However, in reality, everything is much more complicated than it seems at first glance - in the most severe cases, blood can rise through the nasolacrimal canals and flow out through the eye sockets. Also, with severe bleeding, blood through the esophagus enters the respiratory tract or into the gastrointestinal tract and provokes vomiting.
Some people bleed unexpectedly, while others feel dizzy or have headaches and ringing in the ears. It is important not to confuse - there is a possibility of bleeding of other organs (trachea, pharynx, lungs, larynx or even middle ear). The blood from the nose is clean, homogeneous, there are no clots and inclusions in it.
Causes of nosebleeds
Common causes include:
Overheating in the sun (sunstroke) or high fever due to illness.
High pressure drops in the environment (alpinists, divers).
Most often, bleeding is caused by trauma: domestic, industrial and road (the seat belt will protect against contact with the steering wheel or dashboard). Also, bleeding can be triggered by the ingress of a foreign body (children often suffer) or medical manipulations - nasogastric intubation, nasotracheal intubation, etc.
Tumors (specific granulomas, angiomas, etc.) also cause bleeding in the nasal cavity.
Conditions accompanied by mucosal plethora (sinusitis, rhinitis, adenoids).
Violations of the functionality of the mucous membrane (curvature of the nasal septum, atrophic rhinitis).
Stage of purulent inflammation
Acute infectious diseases (eg whooping cough) are often accompanied by acute rhinitis. Even with a generally satisfactory condition of the patient, the respiratory tract becomes very inflamed. There is a cough, often accompanied by vomiting. Tension when coughing often causes nosebleeds.
A lifestyle that provokes regular pressure drops.
Stable high blood pressure.
Bad habits (smoking, alcohol abuse, drugs).
Diseases of the blood, liver, heart.
Side effects of various drugs.
Physical overwork, overheating.
Epistaxis is divided into acute and chronic.
Acute bleeding often leads to complications (eg oxygen deprivation can cause loss of consciousness).
Chronic bleeding, if left untreated, is sometimes even fatal.
By location, bleeding can be anterior or posterior. "Anterior" bleeding does not differ in intensity, stops on its own or with a little help and is quite safe for life.
Posterior bleeding is caused by damage to large blood vessels in the nasal cavity. A large blood loss is possible, so you must immediately call qualified doctors - you cannot stop it on your own.
Nosebleeds in children
Children are more susceptible to nosebleeds. This happens for several reasons:
The mucous membrane is damaged or injured by the child himself.
Intense physical activity.
Hormonal adjustment factors.
Runny nose and infectious diseases.
Solar and heat stroke.
Of the more serious causes, it is worth highlighting various tumors and diseases of the liver. Children also suffer from low blood clotting.
Nosebleeds in adults
There are many causes of nosebleeds in adults - a visit to the doctor and an examination are necessary to determine the specific one. At best, it can be a mild pathology in a completely healthy person, but you should not neglect your health.
Adults and children have different causes of the problem. Blood can enter the sinuses through the respiratory tract, esophagus, or even the stomach. The nasal mucosa is extensively dotted with small blood vessels and capillaries, but regular bleeding from the sinuses almost certainly indicates some serious disease. It is imperative to find out the source of the problem. To do this, you need to undergo a medical examination.
When determining the source of bleeding, it is first necessary to conduct an external examination (the nasal cavity, nasopharynx, esophagus are examined). It is necessary to find out whether we are really dealing with nosebleeds, or a problem in the respiratory or digestive system. In the latter case, in addition to the ENT, it will be necessary to consult with specialized specialists. In any situation, it is useful to involve a therapist in consultation.
Of the necessary tests, you will have to donate blood for biochemistry and clotting.
Complications and consequences
Light bleeding can be stopped on its own, it is not particularly dangerous. However, it is worth subsequently “adding up” all the factors and finding out what served as the “trigger”.
Massive bleeding leads to high blood loss. Subsequently, the work of the whole organism is disrupted - blood pressure drops, the heartbeat quickens, a state of mental retardation occurs.
Bleeding from the nose is not a disease in itself, but may be one of the symptoms of some dangerous disease. You can not ignore the constant bouts of blood from the nose - you need to undergo a complete examination of the body and find out the cause.
Treatment of nosebleeds
Treatment of nosebleeds depends primarily on the causes of its occurrence. First of all, it is necessary to diagnose the source of the pathology. If nosebleeds signal another disease, the main task of specialists is to find out what kind of disease it is and to cope with it. When the disease disappears, you will leave all its symptoms.
In the case when the cause is an increase in blood pressure, it will be enough to normalize it. Medical therapy will relieve you of the problem.
Vascular pathologies require direct intervention. Effectively and quickly, the problem can be solved in two ways - using radio wave or cryosurgical techniques. You can consider both options and choose the appropriate one (the attending physician will advise the best option based on your indications). You will get rid of nosebleeds once and for all.
First Aid for Nosebleeds
If someone has a nosebleed, the medical staff should be contacted first. With a strong loss of blood, in anticipation of medical assistance, you need to raise the head of the victim as high as possible. No need to tilt or tilt it, with heavy bleeding there is a risk that the blood will enter the respiratory tract. First aid is to press the wings of the nose against the septum and apply a cold compress to the forehead / back of the head. You can place cotton or gauze rolls moistened with 3% hydrogen peroxide in the nostrils.
Prevention of bleeding
For people prone to nosebleeds, here are a few tips:
Humidify the air - dry mucous membranes bleed more often.
Moisten the mucous membranes with saline solutions (especially important in winter, when the air in the rooms is too dry due to heaters).
Do not injure the nose, face, head.
Do not inhale irritants. Even if the work is related to acetones, ammonia, solvents or paints, use at least protective equipment.
Get rid of allergies.
Monitor your blood pressure.
Try to avoid SARS and various infectious diseases. Difficult, but limit contact with the sick and contagious, lead a healthy life to the maximum, use masks and bandages during quarantines.
Monitor blood clotting when taking "thinning" drugs.
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Epistaxis: description of the disease, causes, symptoms, cost of treatment in Moscow
When the integrity of the wall of a blood vessel is broken, nosebleeds, or epistaxis, appear. Nosebleeds can occur in both adults and children. The exception is infants who have not reached the age of two. After two years, the activity of the baby increases, which can provoke injury. Also, the child often gets sick with a cold, because of his curiosity, he gets his finger into the nasal cavity, which can cause frequent nosebleeds.
appear The existing causes of nosebleeds in adults are divided into two types. The first type includes local processes:
Degenerative changes in the nasal mucosa. This occurs with an atrophic form of rhinitis, as well as when the nasal septum is curved.
Various injuries of the nose and intranasal structure. Trauma can be industrial, domestic, road. This also includes trauma to the mucosa, when a foreign body enters the nasal cavity, an operation is performed, nasogastric sounding, nasotracheal intubation, catheterization, puncture of the sinuses.
If you inhale hot vapour, caustic substance, gas.
The presence of neoplasms in the nasal cavity (angioma, malignant tumor, granuloma). Cysts or neoplasms in the nose are accompanied by nasal congestion, shortness of breath, headache. There is an intense release of blood, in some cases with an admixture of a clear liquid. If the tumor is located on the adrenal glands, a person's blood pressure rises to 200 units, which can cause frequent nosebleeds in adults.
When the mucosa overflows with blood. This is facilitated by acute or chronic rhinitis, sinusitis, adenoiditis.
Common causes of epistaxis include:
Hormonal imbalance (at puberty, during pregnancy).
In diseases of the cardiovascular system. This is the presence of hypertension, heart disease, vascular anomaly, when a person has increased blood pressure in the head and neck vessels, atherosclerosis. Congenital heart defects provoke children's heart failure. Blood is released for no longer than three to four minutes. Due to increased capillary and venous pressure, the blood has a dark color. Isolation begins spontaneously, with no physical or moral tension. The nose bleeds several times in 7 days.
In pathology caused by sudden changes in barometric pressure. This happens if a person rises to a great height (alpinists and pilots), quickly descends to a depth (divers).
Coagulopathy. This is a painful condition in which there is a violation of blood clotting.
Disease of the circulatory system.
When body temperature is elevated due to an infectious disease.
If heat stroke or sunstroke occurs, overheating.
In addition to the above, frequent nosebleeds in adults cause regular stress, overwork, hypovitaminosis. To eliminate bleeding from the nose, you should fully relax, follow a diet rich in vitamins and minerals. There are cases when the cause of frequent nosebleeds in adults is leukemia, a liver disease that promotes the production of vitamin K. If blood clotting is impaired, there is a change in the analysis of urine and blood, bruising on the skin, and a rash.
The cause of severe nosebleeds is tuberculosis. With bacterial reproduction in the nasal cavity, the formation of tuberculous granuloma occurs. It contributes to the violation of the integrity of soft tissue, cartilage, mucous membranes. The discharge is bright red, sometimes with an admixture of mucus or pus. Blood flows out no longer than three minutes. In addition, among the symptoms of tuberculosis, there is excessive sweating at night, lethargy, and a strong cough.
The section of the nasal cavity is the determining factor for whether bleeding is anterior or posterior. The nature of the anterior bleeding does not differ in intensity, it is not dangerous to human health. If a disease of the circulatory system is not diagnosed, it is able to stop arbitrarily, or with the application of first aid rules. If large vascular trunks located on the wall of the deep part of the nasal cavity are damaged, posterior blood loss begins. It can grow rapidly, as a result, there is a danger to human health and life. This type of bleeding is difficult to stop with home remedies, so you should seek qualified help, which is based on special treatment. Minor blood loss is considered if it is from 10 to 30 ml, light - up to 400 ml, medium - from 700 to 1200 ml, severe - more than 1500 ml.
How to determine the source of bleeding
To determine what type of bleeding is (anterior or posterior), the patient is examined by a doctor. He asks if there is a bloody taste in the mouth, there is a runoff in the throat, if there is vomiting and expectoration with blood. The patient talks about when the symptom appeared, notes the presence or absence of nasal injuries. The doctor finds out what comorbidities a person has (blood pressure rises, kidney or vascular disease, constant medication). The patient specifies whether he has frequent nosebleeds or not, indicates their duration, intensity, age when it started.
After the interview, the doctor performs a pharyngoscopy. This is a procedure when the pharynx is examined under special lighting. The process involves the use of a spatula, forehead reflector, laryngeal and nasopharyngeal mirror. With the help of such instruments, the doctor assesses the condition of the root of the tongue, the back and side walls of the pharynx, the soft palate, the palatine arches, the palatine uvula and the tonsils. The examination includes assessing the color of the mucosa, how smooth it is, whether lymphoid tissue has accumulated, and whether there is a pathological formation.
To determine why nosebleeds appeared, the treatment of which depends on the underlying cause, the doctor performs a rhinoscopy. It refers to a diagnostic instrumental technique that helps to study the state of the nasal cavity. Rhinoscopy is anterior, posterior, middle. Anterior rhinoscopy is performed using a nasal mirror, posterior - with a nasopharyngeal mirror, middle - with a mirror with an elongated branch. The procedure is indicated for the diagnosis of diseases of the nasal cavity. During the middle and posterior rhinoscopy, the patient is given local anesthesia.
Based on how the disease proceeds, nosebleeds in a dream can be single, recurrent, recurring. Recurrent nosebleeds, the repetition of which occurs for a limited time period. They contribute to the deterioration of the general condition of a person, and require inpatient therapy. The formation of an unstable aneurysm, rupture of the ethmoid artery are the causes of such nosebleeds, treatment in adults and children is prescribed by an experienced doctor. In addition, vascular disease can be the cause. The first sign of hypertension is hemorrhage from a ruptured vessel. A person diagnosed with hypertension, nephrosclerosis, wrinkled kidney is at risk of recurrent bleeding.
When this type of bleeding occurs, the development of a mental disorder begins, the signs of which are:
Weakness all over the body.
A person loses the landmark of time and place where he is.
Increased heart rate.
Blood pressure drops to a critical level.
If one of the above symptoms is present, multiple transfusions of blood substitute fluid, isotonic sodium chloride solution, erythrocyte mass, electrolytes are urgently required.