| Subject | Contents |
| Definition | Loss of blood from the mucous membranes that line the nose, most commonly from one nostril only. |
| Alternative Names | Nose bleeding; Nose blood loss; Epistaxis |
| Considerations | Nosebleeds are very common. A nosebleed may be caused by trauma such as nose picking, forceful nose blowing, direct impact to the nose, and similar situations. A nosebleed may also be caused by irritation or dryness of the lining of the nose, which may occur with low humidity and dry environment, allergic rhinitis , colds , or sinusitis . Deviated septum, foreign objects in the nose, or other nasal obstruction may cause also cause nosebleeds.
Most nosebleeds occur on the tip of the nasal septum, which contains many fragile, easily damaged blood vessels. More rarely, nosebleeds may occur higher on the septum or deeper in the nose. These higher or deeper nosebleeds may be harder to control.
Occasionally, nosebleeds may indicate other disorders such as bleeding disorders , hypertension , or arteriosclerosis . Hereditary hemorrhagic telangiectasia (also called HHT or Osler-Weber-Rendu syndrome, a disorder involving a vascular growth similar to a birthmark in the back of the nose) may be evidenced by nosebleeds. Sometimes blood thinners such as Coumadin or aspirin may cause or worsen nosebleeds. Most nosebleeds begin on the septum -- the midline, vertical cartilage that separates the nasal chambers and is lined with fragile blood vessels. This form of nosebleed is not serious, and is usually easy to stop. |
| Causes | Sudden trauma to the nose, very cold or very dry air, fragile blood vessels, nasal sprays, strenuous exercise , or picking the nose cause most nosebleeds . Recurrent nosebleeds may be a symptom of an underlying disorder such as high blood pressure , taking large doses of aspirin or blood-thinning medication, allergies , a bleeding disorder, or a tumor of the nose or sinuses. Most nosebleeds come from blood vessels in the front of the nose. Some are caused by bleeding from the back of the nose into the throat (posterior bleeding) -- these are more difficult to control and almost always require medical attention. |
| Symptoms | Bleeding from one or both nostrils. Frequent swallowing. Sensation of fluid in the back of the nose and throat. |
| First Aid | 1. Calm and reassure the victim. Encourage breathing through the mouth. 2. Have the victim sit down and lean forward slightly. This will help keep blood from going down the back of their throat. Do not have them tip their head backward. 3. Check to see if there is an object in the victim's nose and remove it if necessary. 4. Pinch the soft part of the nose firmly for 5 to 10 minutes without releasing. Place a cold compress on the bridge of the nose. 5. Release the nostrils slowly, and avoid touching or blowing the nose. 6. If bleeding has not stopped after 20 minutes, repeat this procedure one more time. If the nose is still bleeding after a second attempt, seek medical attention. 7. If medical attention is required, the doctor is likely to pack the affected nostril with gauze in order to apply pressure to the ruptured blood vessel. Cauterization (the application of a heated instrument or caustic chemical to tissue to stop bleeding) may be required if bleeding persists or recurs. Note: Ice applied to the nose or the neck has not been proven to help stop nosebleeds , but causes no harm. |
| Do Not | Lying down with a nose bleed is not recommended, and you should avoid sniffing or blowing your nose for several hours after a nosebleed. |
| Call immediately for emergency medical assistance if | Bleeding persists after 15 to 20 minutes of treatment, nosebleeds recur, or blood persistently drains down the throat. A neck or serious head injury is suspected. |
| Prevention | Avoid putting fingers into the nose. Humidify air to prevent dryness. For minor recurrent nosebleeds , apply a small amount of petroleum jelly (such as Vaseline) in the nostrils at night for 1 to 2 weeks. |
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