Nose bleed or Epistaxis means sudden start of bleeding from nose.It usually affects children but adults also suffer from it .If a child repeatedly has problem of nose bleed it worries his parents because if bleeding is not controlled immediately child gradually becomes weak due to decrease in hemoglobin level . Frequent nose bleed forces the child to stay at home many a times which effects his studies.
Human nose has a very thin mucosal lining underneath which is a network of fine capillaries the capillaries at lower part of nasal septum are vulnerable to bleed on slight trauma . The common causes of nose bleed are trauma to face or nose ,habit of nose picking specially in children.Other important causes of nose bleed in children are insertion of foreign bodies like grains, pieces of stones,pieces of paper , a small toy or a piece of a
toy which gets lodged in nostril and leads to epistaxis .cold weather causes dryness of nasal mucosa which can lead to nose bleeding .Cigarettes smoking can lead to nasal bleeding because it effects nasal mucosa . Passive smokers especially children are at risk for nose bleed because their nasal mucosa is very thin and delicate and can bleed because of unpleasant effect of cigarette smoke . Nose bleed also occurs in patients with chronic sinusitis and enlarged adenoid glands, nasal allergy and deviated nasal septum .
Coagulation disorders like hemophilia and purpura usually cause repeated attacks of nose bleed.Diseases like Typhoid, measles ,and jaundice can also lead to nose bleed.In adults with hypertension nose bleed can occur as a warning sign of sudden increase in blood pressure and immediate management of nose bleed and blood pressure can save the patient from imminent Cerebro-vascular accident or heart attack.
To control nose bleed the patient is reassured and made to sit with head slightly bending forward, so that blood should not enter respiratory and digestive tracts.children need special attention as they usually start crying which further increases bleeding. The part of nose just below the bony part is pinched between thumb and finger for five minutes ,after that pressure is released and you have to watch whether bleeding has stopped or not ,if it has not stopped pinch again for about ten more minutes. Ice packs also help to control bleeding if applied on nose. Now if bleeding has stopped then ask the patient to lie down with head raised with the help of pillows .He should neither exert nor bend his head forward for next 24 hours and should be given light diet.if bleeding does not stop after 15 minutes patient needs to be taken to hospital where nasal pack is applied for few hours and later on if required cautry of that particular area from where repeated blending occurs is performed
.To prevent repeated episodes of nasal bleeding patient needs to be educated to stop habit of nose picking,.play area of children should be neat and no small pieces of any material left there. In dry weather nose oil should be applied in the nostrils to prevent mucosal dryness.Patients of high blood pressure should have regular check ups and take prescribed medicines regularly and if they start epistaxis they should take it as a sign of sudden increase in their blood pressure,and immediately consult their doctor .If some one is suffering from fever, cough, measles or Typhoid fever proper treatment should be taken .Cigarette smoking should be avoided especially indoors.preventive measures if properly adopted decrease the risk of nose bleed.
Human nose has a very thin mucosal lining underneath which is a network of fine capillaries the capillaries at lower part of nasal septum are vulnerable to bleed on slight trauma . The common causes of nose bleed are trauma to face or nose ,habit of nose picking specially in children.Other important causes of nose bleed in children are insertion of foreign bodies like grains, pieces of stones,pieces of paper , a small toy or a piece of a
toy which gets lodged in nostril and leads to epistaxis .cold weather causes dryness of nasal mucosa which can lead to nose bleeding .Cigarettes smoking can lead to nasal bleeding because it effects nasal mucosa . Passive smokers especially children are at risk for nose bleed because their nasal mucosa is very thin and delicate and can bleed because of unpleasant effect of cigarette smoke . Nose bleed also occurs in patients with chronic sinusitis and enlarged adenoid glands, nasal allergy and deviated nasal septum .
Coagulation disorders like hemophilia and purpura usually cause repeated attacks of nose bleed.Diseases like Typhoid, measles ,and jaundice can also lead to nose bleed.In adults with hypertension nose bleed can occur as a warning sign of sudden increase in blood pressure and immediate management of nose bleed and blood pressure can save the patient from imminent Cerebro-vascular accident or heart attack.
To control nose bleed the patient is reassured and made to sit with head slightly bending forward, so that blood should not enter respiratory and digestive tracts.children need special attention as they usually start crying which further increases bleeding. The part of nose just below the bony part is pinched between thumb and finger for five minutes ,after that pressure is released and you have to watch whether bleeding has stopped or not ,if it has not stopped pinch again for about ten more minutes. Ice packs also help to control bleeding if applied on nose. Now if bleeding has stopped then ask the patient to lie down with head raised with the help of pillows .He should neither exert nor bend his head forward for next 24 hours and should be given light diet.if bleeding does not stop after 15 minutes patient needs to be taken to hospital where nasal pack is applied for few hours and later on if required cautry of that particular area from where repeated blending occurs is performed
.To prevent repeated episodes of nasal bleeding patient needs to be educated to stop habit of nose picking,.play area of children should be neat and no small pieces of any material left there. In dry weather nose oil should be applied in the nostrils to prevent mucosal dryness.Patients of high blood pressure should have regular check ups and take prescribed medicines regularly and if they start epistaxis they should take it as a sign of sudden increase in their blood pressure,and immediately consult their doctor .If some one is suffering from fever, cough, measles or Typhoid fever proper treatment should be taken .Cigarette smoking should be avoided especially indoors.preventive measures if properly adopted decrease the risk of nose bleed.
Rayford
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Our experience
The frontal opening can occur on either side (our case it was the right side) and will look like a very tiny volcano once all the blood is suctioned away to see it clearly. This may need to be cauterized with either electric shock or an acid burn matchstick depends on your doctor and his tools. Frontal leaks above the underlying artery can be difficult partly because of the tendency to fuss over the nose with tissues and such catching and wiping away the blood and therefore facilitating the failure to clot and scab properly. It also tends to itch because the nose is so sensitive and the condition can cause other distress because of the need to mouth-breath. Drinking water and soups helps to replenish lost fluids needed to help rebuild lost blood cells.
An ENT will have the right tools to choose from because most of them see at least 1 nosebleed patient a day. We were then instructed to spray AFRIN up the bleeding nostril and pinch the whole nose tightly but NOT powerfully for 5 minutes. If that fails, spray it again and pinch it for 15 whole minutes by the clock. If that fails seek out an ENT and see him for further investigation and proper treatment.
The emergency room (ER) is only logically useful when the bleeding may exceed 1 liter and approach life threatening blood loss levels. 1 liter over a week or two is not all that much but 1 liter over a 24-48 period is obviously dangerous if it is allowed to continue (human body only having 5 liters or so total). Symptoms here are patient feels clod and heart rate will increase when blood loss has become an issue and an ER should be seen.
The ER tends to focus not on complete and excellent treatment, but on ensuring there will not be loss of life. As such a simple nosebleed at an ER will usually be treated by painfully cramming a huge tampon to the back of the nostril to protect against a back of the nose leak (second most common area). The risk here is if the patient is leaking backward and swallowing large amounts of blood they might die in their sleep. Just be warned the ER is a last resort and an ENT is almost always going to be preferable.
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