NOSEBLEED (Epistaxis) |
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General Information
DEFINITION--Bleeding from the nose. This is common in athletes who participate in contact or collision sports, especially football, boxing, wrestling or hockey.
SIGNS & SYMPTOMS
Blood oozing or gushing from the nostril. If the nosebleed is close to the nostril, the blood is bright red. If the nosebleed is deeper in the nose, the blood may be bright or dark.
Lightheadedness from blood loss.
Rapid heartbeat, shortness of breath and pallor (with significant blood loss only.)
CAUSES & RISK FACTORS
Injury to the nose.
Nasal or sinus infection.
Nasal polyps or a foreign body in the nose.
Use of certain drugs, such as anticoagulants, aspirin, or prolonged use of nose drops.
Exposure to irritating chemicals.
High altitude or dry climate.
Dry nasal membranes from any cause.
Atherosclerosis (hardening of the arteries).
High blood pressure.
Bleeding tendencies associated with aplastic anemia, leukemia, hemophilia, thrombocytopenia or liver disease.
Hodgkin's disease.
Scarlet fever.
Scurvy.
Rheumatic fever.
HOW TO PREVENT
Avoid injury if possible. Use appropriate equipment to protect the face and head.
Obtain medical treatment for any known underlying cause.
Humidify the air if you live in a dry climate or at high altitude.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
Laboratory blood studies.
SURGERYMay be necessary in cases of severe bleeding to tie off the artery feeding the bleeding area.
NORMAL COURSE OF ILLNESSSymptoms can be controlled with treatment. Severe bleeding requires hospitalization and usually is caused by an underlying disorder, such as liver disease, blood disease or hypertension. In these cases, the disorder must also be treated.
POSSIBLE COMPLICATIONS
Bleeding severe enough to require transfusion.
Nasal and sinus infections.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENT
Doctor's or emergency-room treatment if there is a nose fracture or other injury, or if home treatment is unsuccessful. Gauze packing may be inserted to absorb blood, stop dripping and exert pressure on the ruptured blood vessels. Continued bleeding may require cauterization (See Glossary) and packing.
Surgery (for severe bleeding only).
HOME TREATMENTIf there has been no serious injury to the nose:
Sit up with your head bent forward.
Clamp your nose closed with your fingers for 5 uninterrupted minutes. During this time, breathe through your mouth.
If bleeding stops and recurs, repeat--but pinch your nose firmly on both sides for 8 to 10 minutes. Holding your nose tightly closed allows the blood to clot and seal the damaged blood vessels.
You may apply cold compresses at the same time.
Don't blow your nose for 12 hours after bleeding stops because you may dislodge the blood clot.
Don't swallow blood. It may upset your stomach, or make you "gag" or vomit, causing you to inhale blood.
Don't talk excessively, laugh or sing. These may cause gagging.
MEDICATIONYour doctor may prescribe drugs to treat any underlying serious disorder.
ACTIVITYResume your normal activities when bleeding has stopped for 24 hours.
DIETNo special diet.
CALL YOUR DOCTOR IF
You have a nosebleed that won't stop with home treatment described above.
After the nosebleed, you become nauseated or vomit.
After the nose has been packed, your temperature rises to 101F (38.3C) or higher.
Renewed bleeding or signs of infection (fever and a general ill feeling) begin after surgery.
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