First
Aid - Nosebleeds (Epistaxis)
Why
do people get nosebleeds?
The nose is a part of the body that is very rich in
blood vessels (vascular) and is situated in a vulnerable
position on the face. As a result, any trauma 
to
the face can cause bleeding. The bleeding may be profuse,
or simply a minor complication. Nosebleeds can occur
spontaneously when the nasal membranes dry out, crust,
and crack. This is common in dry climates, or during
the winter months when the air is dry and warm from
household heaters. People are more susceptible to
bleeding if they are taking medications which prevent
normal blood clotting (COUMADIN, warfarin, aspirin,
or any anti-inflammatory medication). In this situation,
only a very minor trauma could result in significant
bleeding.
The
incidence of nosebleeds is higher during the colder
winter months when upper respiratory infections are
more frequent, and the temperature and humidity fluctuate
more dramatically. In addition, changes from a bitter
cold outside environment to a warm, dry, heated home
results in drying and changes in the nose which will
make it more susceptible to bleeding. Nosebleeds also
occur in hot dry climates with low humidity, or when
there is a change in the seasons. The following list
of factors predispose people to nosebleeds:
- Infection
- Trauma
- Allergic
and non-allergic rhinitis
- Hypertension
- Use
of "blood thinning medications"
- Alcohol
abuse
- Less
common causes include, tumors and inherited bleeding
problems
How
do you stop the common nosebleed?
Most people who develop nose bleeding can handle the
problem without the need of a physician if they follow
the recommendations below:
- Pinch
all the soft parts of the nose together between
your thumb and index finger.
- Press
firmly toward the face - compressing the pinched
parts of the nose against the bones of the face.
- Hold
the nose for at least 5 minutes (timed by the clock).
Repeat as necessary until the nose has stopped bleeding.
- Sit
quietly, keeping the head higher than the level
of the heart; that is, sit up or lie with the head
elevated. Do not lay flat or put your head between
your legs.
- Apply
ice (crushed in a plastic bag or washcloth) to nose
and cheeks
How
do you prevent the nose from bleeding again?
- Go
home and rest with head elevated at 30 to
45 degrees.
- Do
not blow your nose or put anything into it. If you
have to sneeze, open your mouth so that the air
will escape out the mouth and not through the nose.
- Do
not strain during bowel movements. Use a stool softener
(for example, COLACE).
- Do
not strain or bend down to lift anything heavy.
- Try
to keep your head higher than the level of your
heart.
- Do
not smoke. Stay on a soft cool diet. No hot liquids
for at least 24 hours.
Do
not take any medications which will "thin the blood"
(aspirin or aspirin products). If these have been
prescribed by your primary care physician, you need
to contact him or her regarding stopping these medications.
Your
doctor may recommend some form of lubricating ointment
for the inside of the nose (see below).
If re-bleeding occurs, try to clear the nose of clots
by sniffing in forcefully. You can try using a nasal
decongestant spray, such as AFRIN, DURATION, or NEO-SYNEPHRINE.
These
types of sprays constrict blood vessels. (NOTE: If
used for many days at a time, these can cause addiction.)
Repeat
the steps above on how to stop the common nose bleed.
If bleeding persists, then call your doctor and/or
come to the emergency room.
