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is a nosebleed?
occurs when the membranes lining the inner nose are disturbed
or irritated enough to cause abnormal bleeding. The medical
term for nosebleed is epistaxis. There are two types of nosebleeds:
anterior and posterior. If the bleeding is near the front
of the nose, it is an anterior nosebleed. Nosebleeds in children
are almost always of the anterior type. Anterior nosebleeds
are common in dry climates or during the winter months when
the dry air parches the nasal membranes so that they crust,
crack, and bleed. A posterior nosebleed occurs in the back
of the nose and is not always characterized by rapid bleeding
but may be slow, steady ooze. Posterior nosebleeds are more
likely to occur in older people. It may be more difficult
to locate the site of the damage in a posterior nosebleed
than in an anterior nosebleed. An anterior nosebleed is usually
not as severe or serious as a posterior nosebleed.
you have a nosebleed after a heavy blow to your skull, it
could mean you have a fractured skull. You should go to the
common causes of nosebleed are:
breakdown in the membranes lining the nose. This can be
triggered by poorly humidified air or probing, bumping,
picking, or rubbing your nose.
the nose forcefully can also cause a nosebleed, especially
if the nasal lining is already inflamed because of a virus,
bacteria, or allergy.
to the face or nose.
and damage from previous nosebleeds that reopen and bleed.
that slow the time normally required for the blood to clot.
is the nose prone to bleeding?
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.
are the symptoms of nosebleeds?
of anterior nosebleed include intermittent or constant bleeding
out of the front of the nose. Blood can flow from one or both
nostrils and can flow into the throat. Symptoms of posterior
nosebleed include bleeding that stops and starts, rapid bleeding
from the back of the nose, or a slow, steady ooze. Sometimes
the blood flows back into the throat. Especially with posterior
nose bleeding, one can lose blood quickly.
are nosebleeds treated?
may be treated by first aid, packing, cauterization, surgical
procedures including reconstruction of the nasal septum and
arterial ligation, and embolization.
Aid for Nosebleeds
common nosebleeds will stop after the application of first
aid by the patient.
your nose starts bleeding, sit up and lean forward to prevent
blood from passing into your throat, which may cause choking.
the nose firmly together between the thumb and index finger,
just below the nasal bones, and hold it for 10 minutes.
a cotton ball or pad with a saline nasal spray and press
it against the bleeding part of the nose if possible.
a nosebleed does not respond to first aid or lasts more
than 20 minutes, it is necessary to see an ENT specialist.
is a procedure used to force the blood to clot (coagulate)
at the site of the bleeding. Cautery may be done with silver
nitrate or with an electrocautery instrument. Electrocautery
is usually reserved for more severe bleeding and posterior
nosebleeds, and usually requires the use of local anesthesia.
packing may be used to treat nosebleeds not responsive to
cautery. Packing for anterior nosebleeds (near the front of
the nose) is relatively simple. Packing for posterior nosebleeds
(in the back of the nose) can be more difficult and uncomfortable.
For posterior nosebleeds, rolled gauze or recently developed
inflatable balloon devices may be used. If a posterior pack
is placed, an anterior pack will also be used as well. Patients
will receive antibiotics to prevent infection. Patients should
never remove their packing; severe bleeding and improperly
handled packing can be fatal.
Treatment of Nosebleeds
most nosebleeds stop with cautery and/or packing, severe or
recurrent bleeding may require surgical treatment. Procedures
examination under general anesthesia and Septoplasty (surgical
reconstruction of the nasal septum)
may fail because of lack of cooperation (especially among
children) or from problems such as a deviated septum. An endoscopic
exam under general anesthesia may be performed, bleeding sites
may be cauterized, deviated septum may be straightened, packing
may be replaced, and arterial ligation may be performed during
the same procedure, if necessary.
ligation involves constricting specific blood vessels in order
to stop bleeding. Procedures may require local or general
entails the introduction of a substance into a blood vessel
in order to close it and prevent bleeding
can I help prevent a nosebleed?
of nosebleeds can be prevented or managed as follows:
you have a nasal infection, keep your nose well coated with
a petrolatum- based ointment or an antibiotic ointment until
your nose heals (usually 3 to 5 days).
injuring the nasal mucosa with nose-picking, rubbing, or
a saline nasal spray to keep the nose moist.
not pick or blow nose (sniffing is all right).
children's fingernails short to discourage nose picking.
smoking. Smoking dries out your nose and also irritates
your mouth when you sneeze.
Dr.Kumaresh Krishnamoorthy, M.S (ENT)
and Neck Surgery Fellowship (Buffalo, USA)
& Skull Base Surgery Fellowship (Cincinnati, USA)
Consultant in ENT - Head and Neck Surgeon and Skull Base Surgeon
Hospitals, 154/11, Bannerghatta Road, BANGALORE 560 076, INDIA
91-(0) - 99002 36819