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Nosebleed

(Epistaxis; Bloody Nose)

Definition

Nosebleed refers to blood flowing from the nose or nasal passage. There are two types of nosebleeds:
The Nasal Passage
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Causes

Nosebleeds may be caused by:

Risk Factors

Factors that may increase your risk of nosebleeds include:

Symptoms

Nosebleed symptoms depend on where in the nose the bleeding begins, for example:

When Should I Call My Doctor?

Call your doctor if:
  • There is a lot of blood
  • The bleeding will not stop
  • The bleeding is caused by an injury
  • You experience frequent nosebleeds
  • The bleeding interferes with breathing
  • The bleeding happens in a child less than 2 years of age

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Your doctor may want to do certain tests, such as:

Treatment

Most anterior nosebleeds stop without medical care within 15 minutes. Posterior nosebleeds usually are more serious and need medical care. Treatment may include sealing off the blood vessel that is bleeding.

Self-Care

  1. Stay calm.
  2. Sit up and lean forward.
  3. Pinch the soft parts of your nose together. Hold for at least five minutes without releasing pressure.
  4. Once the bleeding stops, do not pick or blow your nose.
  5. Avoid straining, bending, or lifting.
  6. If the bleeding starts again, reapply pressure for ten minutes.

Medical Intervention

For an anterior nosebleed, your doctor will use a compress soaked in a medication. The medication constricts or shrinks the blood vessel and reduces the pain. Pressure will be applied by pinching the nostrils together. Your doctor may pack the area with gauze. In more severe cases, your doctor may cauterize (seal off) a blood vessel that does not clot on its own.
A posterior nosebleed may require packing the nostril or inserting and inflating a special balloon that applies pressure to the area. If all medical attempts to control bleeding fail, surgery may be needed.

Prevention

To help reduce your chance of getting a nosebleed:

RESOURCES

American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org

Family Doctor—American Academy of Family Physicians http://familydoctor.org

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca

Canadian Society of Otolaryngology http://www.entcanada.org

References

Epistaxis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 15, 2014. Accessed September 22, 2015.

Nosebleeds. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/nosebleeds.html. Updated April 2014. Accessed September 22, 2015.

Nosebleeds. American Academy of Otolaryngology website. Available at: http://www.entnet.org/content/nosebleeds. Updated December 3, 2010. Accessed September 22, 2015.

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