NosebleedsNosebleeds can be dramatic and frightening, fortunately most cases are not serious and can be handled fairly easily.
They can occur at any age but are most common in children aged 2 to 10 years and adults aged 50 to 80 years.
In the United States they are fairly common,one of every seven people will develop a nosebleed at some time.
Nosebleeds can be anterior (from the front of the nose, easier to control, represent 90% of the cases) and posterior (fairly rare, affect more often elderly people).
First Aid for a Nosebleed
To stop a nosebleed:
- Remain calm.
- Sit up straight.
- Pinch the nose together between your thumb and index finger and press firmly toward the face.
- Lean forward slightly with the head tilted forward. Do not lean back as the blood will run back into your sinuses and throat and can cause gagging or inhaling the blood.
- Hold the nose for at least five minutes. Repeat as necessary until the nose has stopped bleeding.
How to prevent the nose from bleeding again
- Rest with your head higher than the level of your heart.
- Do not blow your nose or put anything into it. If you have to sneeze, open your mouth.
- Do not strain during bowel movements or bend down to lift anything heavy.
- Adopt a soft diet-no hot liquids or smoking for at least 24 hours.
- Do not take any medications that will thin the blood (aspirin, ibuprofen, clopidogrel or warfarin). If these have been prescribed by your physician, please contact him.
Causes for nosebleeds
The nose is highly vascularised and has a vulnerable position, thus trauma such as a blow to the face, nose picking or irritation due to a cold can cause bleeding.
Nosebleeds can occur spontaneously, when due to fluctuating weather conditions the nasal membranes dry out and crack.
People with blood clotting inability (due to disease or medication which prevents normal blood clotting) have more a risk to get nosebleeds.
High blood pressure alone is rarely a reason for nosebleeds although it is a contributing factor.
Bleeding usually occurs from one nostril, but the blood can fill up the nostril and spill on the other side causing bleeding from both sides. Blood can also drip back into the throat or stomach, causing a person to spit or even vomit blood.
Signs of excessive blood loss include dizziness and fainting.
- It is often helpful to try lubricating the inside of the nose with an ointment.
- Moisturising the air with a humidifier or vaporizer will help keep the nose from drying out.
- You can temporarily use a nasal decongestant spray (e.g.Afrin), but only for a short-term period, as it can cause addiction. Also, do not use if you have high blood pressure.
- Saline mist nasal spray is often helpful.
If the nosebleed persists or is recurrent, see your doctor, who will stop the nosebleed with a heating instrument or chemical swab or may place nasal packs, which compress the vessels and stop the bleeding.
When to Seek Medical Care for a Nosebleed
- If you have repeated episodes of nosebleeds.
- If you also have blood in the urine or stool.
- If you have blood clotting inability (due to disease or medication which prevents normal blood clotting), bruise easily or recently had chemotherapy.
Go to the hospital for nosebleeds if:
- Bleeding continues after pinching the nose for 10 minutes, you feel faint from blood loss, have short breath and rapid heartbeat.
- You are spitting up blood, have a rash, a fever or a headache
- If bleeding is rapid, or if blood loss is large.
- If your infant or baby has a nosebleed, contact the paediatrician.
Common causes for nosebleeds are drying of the nasal membranes and nose picking. This can be prevented with proper lubrication of the nasal passages and not picking the nose.
Most nosebleeds can be stopped at home and with proper care there are no long-term effects.
Consult a doctor for a nosebleed if bleeding cannot be stopped, the amount of blood lost is large, or you feel weak or faint.
Do not take aspirin or other blood thinning products when you get a nosebleed (consult your doctor before stopping any medication).
If another disease is causing the bleeding, the prognosis depends on discovering and treating that disease.
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