ENT Emergency – Nose Bleeding

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Nose bleeding is a common problem and may happen in children, teenagers or adults. It is called Epistaxis in medical terminology. Nose bleed can be anterior, which is more common or posterior.

What you can do

Paediatric age group – Nose bleed is most commonly anterior and self limiting

  • Pinch the nostril
  • Ask child to breathe through mouth
  • Keep head back
  • Reassure
  • Ice pack can also be applied on the nose, neck etc.

 

Adults

  • Hypertensive patients are more prone.
  • Check blood pressure and reduce if elevated
  • Pinch the nostril and reassure the patient
  • If it is recurrent see your doctor- coagulogram
  • Stop blood thinners eg ecosprin etc
  • Avoid blowing nose hard
  • Avoid moving in hot sun

Management of Epistaxis at ENT centre

  • ENT examination – identify, treat/cauterize/ ligate
  • Nasoendoscopy –identify/ cauterize/ligate
  • Nasoendoscopy may reveal other causes of epistaxis – polyps, sinusitis, growth
  • May need nasal packing -anterior in most cases

 

Points to remember

  • Epistaxis is not inevitable – the child will have it in summers – ‘naksir’ concept, any unexplained blood loss is cause for concern, should not be neglected.
  • Majority of epistaxis is anterior and from little’s area.
  • Nasoendoscope has revolutionalized management, packing very occasionally required.
  • Avoid adrenaline packs – rebound, aggravate cardiac condition.

 

Check out our new series of articles on medical emergencies of the ENT, Ear, Nose and Throat. Up Next Foreign Body in Nose.