AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

Learn essential emergency treatments for nosebleeds with Meri Sehat. Be prepared to respond effectively in nosebleed situations.

Emergency Treatment For Nosebleed

Introduction

Epistaxis or nosebleeds can be frightful, but nothing serious. They can usually be treated at home and are rarely a symptom of anything dangerous. 

However, frequent or severe nosebleeds can be a sign of more significant health issues, including high blood pressure, anemia, or clotting, and should be investigated immediately. At least 60% of individuals experience a nosebleed at some point in their lives.<a href="#accordion">[5]</a> 
&nbsp;

Epistaxis is responsible for nearly 0.5% of emergency room visits and up to one-third of otolaryngology-related emergencies. Moreover, 0.2% of individuals with severe nosebleeds require aggressive inpatient hospitalization.<a href="#accordion">[2]</a>

Sometimes, nosebleeds occur due to certain environmental and physiological conditions. In a few extreme circumstances, though, they might happen repeatedly. While nosebleeds can happen to anyone, they frequently affect: 
&nbsp;

<ul>
	<li>Children between the ages of 2 and 10</li>
	<li>Old people</li>
	<li>Pregnant women</li>
	<li>People who use blood thinning medication, like warfarin or aspirin</li>
	<li>People with clotting problems, like hemophilia</li>
	<li>People with high blood pressure; their nosebleeds tend to be heavier and/or last longer 
	&nbsp;</li>
</ul>

The majority of nosebleeds don&#39;t require any attention, but some do. Immediately seek medical attention if: 
&nbsp;

<ul>
	<li>You&rsquo;re still bleeding after 20 minutes</li>
	<li>Bleeding is due to head injury</li>
	<li>The nose feels fractured</li>
	<li>Bleeding is associated with difficulty in breathing or vomiting</li>
	<li>Bleeding is rapid or large in amount (more than a cup) 
	&nbsp;</li>
</ul>

Understanding the Emergency Treatment for Nosebleed

<ul>
	<li>Anterior Nosebleed: This means you&rsquo;re bleeding from your nostril, i.e., the front of your nose. It is possible to treat this type of nosebleed at home. 
	&nbsp;</li>
	<li>Posterior Nosebleed: This requires a more invasive treatment since you&rsquo;ll be bleeding from the back of your nose. It&rsquo;s less common but more serious; there&rsquo;s a greater risk the blood flows down your throat. Go to the ER immediately! 
	&nbsp;</li>
</ul>

The only way to successfully control extremely persistent epistaxis is to follow a planned, step-by-step treatment plan.

Here are 5 fast steps you can do to lessen and stop bleeding: 
&nbsp;

<ol>
	<li>
	Sit Up Straight And Forward
	</li>
</ol>

When you get a nosebleed, the desire to pull back to stop the blood from running down your face is very strong. The ideal option, though, is to move your head forward. But, do NOT put your head between your legs.

This is to ensure the blood doesn&#39;t enter your throat, which can lead to nausea and vomiting. Try to be calm and concentrate on breathing through your mouth rather than your nose. 
&nbsp;

<ol start="2">
	<li>
	Don&rsquo;t Pack Your Nose 
	</li>
</ol>

Some people will attempt to stop bleeding by sticking tissues and cotton pads in their noses. This might make bleeding worse. Instead of trying to block the blood flow, use a tissue or damp washcloth to catch the blood. 
&nbsp;

<ol start="3">
	<li>
	Spray A Decongestant 
	</li>
</ol>

A decongestant spray contains drugs that constrict the blood vessels in the nose. In addition to reducing swelling and congestion, this can help relieve or stop bleeding.&nbsp; Avoid using it for a long time as that would increase the risk of another nosebleed. 
&nbsp;

<ol start="4">
	<li>
	Pinch Your Nose
	</li>
</ol>

You can stop bleeding by gently pinching the fleshy, soft area of your nose beneath the nasal bones for about 5 minutes. Then check if the nosebleed has stopped. If it hasn&rsquo;t, squeeze it for another 10 minutes. 
&nbsp;

<ol start="5">
	<li>
	Repeat 
	</li>
</ol>

Repeat steps 1-4. Seek emergency medical attention if you are bleeding heavily, have trouble breathing, or can&#39;t stop the bleeding after 20 minutes of trying. 
&nbsp;

Note: You can also apply an ice pack to the bridge of your nose, however do not apply ice directly on your skin. 
&nbsp;

After the bleeding has stopped, there are some after-care instructions to follow to avoid another nosebleed. 
&nbsp;

<ol>
	<li>
	<h5>Don&rsquo;t Pick Your Nose</h5>
	</li>
</ol>

Frequent nose-picking irritates your nasal membranes. Picking your nose after having recently experienced a nosebleed greatly increases your chance of experiencing another one. 
&nbsp;

<ol start="2">
	<li>
	<h5>&nbsp;Don&rsquo;t Blow Your Nose</h5>
	</li>
</ol>

One nosebleed makes another far more likely if you blow your nose within 24 hours of the previous one. Avoid doing it too frequently or too hard. 
&nbsp;

<ol start="3">
	<li>
	<h5>Don&rsquo;t Bend Down</h5>
	</li>
</ol>

A nosebleed can be triggered by bending over, lifting something heavy, or exerting yourself in any way. Limit yourself to light activities for the first 24-48 hours following a nosebleed. 
&nbsp;

<ol start="4">
	<li>
	<h5>&nbsp;Use An Ice Pack</h5>
	</li>
</ol>

Use an ice pack. Make sure the ice pack is covered in a cloth and don&rsquo;t leave it on the site of injury for more than 10 minutes at a time to avoid damaging your skin. Ice packs also help reduce swelling. 
&nbsp;

1. Keep The Lining Of The Nose Moist

Dried-out mucus membranes are a major cause of nosebleeds. A saline spray can be beneficial in this case. Apply it every 2-3 hours.

If sprays don&rsquo;t work for you, you can also try nasal gels or even apply petroleum jelly to the nostril. 
&nbsp;

&nbsp;2. Trim Your Fingernails

Someone who has had a nosebleed should avoid long, sharp fingernails. Nose-picking is usually an unconscious act. For instance, you might pick your nose while sleeping. If your fingernails are not trimmed, you&rsquo;ll have another nosebleed.

Note: This advice also applies to children. 
&nbsp;

3. Use A Humidifier

Humidifiers assist in preventing the mucous membranes from drying out. You can use a humidifier at night to stop nosebleeds while you sleep. Just be sure to clean the humidifier as per the manufacturer&#39;s directions otherwise, germs and mold will accumulate there. 
&nbsp;

4.&nbsp;Wear Protective Equipment

Wear protective equipment if you participate in sports like basketball where injuries are more likely to happen. This is important especially if you have a history of nosebleeds.

Alternatively, you can also cover your nose with a transparent mask, which reduces the possibility of nosebleeds and nasal injuries. 
&nbsp;

5. Avoid Blowing your Nose too Forcefully 
&nbsp;

6.&nbsp;Quit Smoking

Smoking dries out your nose and irritates it. 
&nbsp;

7. Sneeze Through An Open Mouth

Sneeze through an open mouth. Always sneeze into tissue or into the bend of your arm. 
&nbsp;

8.&nbsp;Be Very Cautious

Be very cautious in using medications that can increase bleeding, such as Aspirin and Ibuprofen. Always consult your doctor before taking any medications especially the ones mentioned above. 
&nbsp;

Usually, a nosebleed is nothing to worry about. If you experience nosebleeds frequently or for more than 30 minutes, then your doctor may recommend an ENT.

To begin with, your doctor may ask you about any medications, dietary supplements, or herbs you&rsquo;re currently taking that might be causing nosebleeds,

They will examine your nose and nasal passages for any unusual cause of a nosebleed, like a foreign object, tiny nasal polyps, or abnormally big blood vessels.

While the treatment you receive will vary according to the cause and type of nosebleed you have, doctors generally treat recurrent nosebleeds with: 
&nbsp;

<ul>
	<li>Cautery</li>
</ul>

In this method, blood arteries are repaired using heat or chemicals. 
&nbsp;

<ul>
	<li>Medications</li>
</ul>

The doctor may employ cotton or cloths soaked in medicine. The medications promote blood clotting, which reduces the likelihood of nosebleeds. It is also possible that the dose of certain medications needs to be adjusted e.g. blood thinning medications. Your doctor can best advice you on that. 
&nbsp;

<ul>
	<li>Trauma Correction</li>
</ul>

Depending on whether your nose is fractured or contains a foreign item, the doctor will, fix the fracture or remove the object respectively. 
&nbsp;

Conclusion

Nosebleeds can be annoying, but they are rarely dangerous to your health. If you follow preventive measures and careful treatment, you should be able to stop the bleeding fairly quickly. Consult your doctor if you continue to get frequent nosebleeds. 
&nbsp;

Key Takeaways

<ul>
	<li>Numerous factors, including dry air, nose picking, and allergies, can result in nosebleeds. Sometimes, though, there is no known reason for nosebleeds.</li>
	<li>Children frequently experience nosebleeds.</li>
	<li>Pinching your nostrils till the bleeding stops is a first-aid procedure.</li>
	<li>Consult a physician or a hospital emergency room if the bleeding doesn&rsquo;t stop. 
	&nbsp;</li>
</ul>

[1] Zhang D, Resto V, Goodwin JS. Demographic, Seasonal, and Geographic Differences in Emergency Department Visits for Epistaxis. Otolaryngol Head Neck Surg. 2017 Jan;156(1):81–6.

[2] Tunkel DE, Anne S, Payne SC, Ishman SL, Rosenfeld RM, Abramson PJ, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Neck Surg. 2020;162(1\_suppl):S1--S38.