Epistaxis

1. Epistaxis By Jessica Davies

2. What is Epistaxis? • Epistaxis more commonly known as a Nose Bleed • 2 types: • Anterior (front of the nose) • Posterior (back of the nose)

3. Anterior Nose Bleeds • Make up more than 90% of all nosebleeds • Bleeding usually comes from a blood vessel at very front part of the nose • Usually easy to control, either by measures that can be performed at home or by a doctor.

4. Posterior Nose Bleeds • Much less common than anterior nosebleeds • Tend to occur more often in elderly people • Bleeding usually comes from an artery in the back part of the nose • These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

5. What causes it? • Most Common Reasons(Trauma): • Blow to the face • Picking your nose • Constant irritation for a cold • Least Common Reasons(Underlying Disease): • Unable to create blood clots(i.e. Liver disease) • Abnormal blood vessels • Cancer • High Blood Pressure

6. Symptoms • Usually bleeding occurs from only one nostril • If bleeding is heavy it can bleed from both and even over flow into stomach • Signs of excessive blood loss include dizziness, light-headedness, confusion, and fainting • Excessive blood loss from nosebleeds does not often occur.

7. Treatment • To stop a nosebleed: • Remain calm. • Sit up straight. • Lean your head forward. Tilting your head back will only cause you to swallow the blood. • Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier. • Spit out any blood in your mouth. Swallowing it may make you vomit.

8. Treatment continued… • After the bleeding has stopped: • Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours. • Ice packs do not help. • Exposure to dry air, such as in a heated home in the winter, can contribute to the problem. Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.

9. When is it serious? • When to call the doctor about nosebleeds: • If you have repeated episodes of nosebleeds • If you have additional bleeding from places other than the nose, such as in the urine or stool • If you bruise easily • If you are on any blood-thinning drugs, including aspirin or warfarin (Coumadin) • If you have any underlying disease that may affect your blood clotting, such as liver disease, kidney disease, or hemophilia (inability of blood to clot) • If you recently had chemotherapy

10. When is it serious? • Go to the hospital for nosebleeds if: • You are still bleeding after pinching the nose for 10 minutes. • You are having repeated episodes of nosebleeds over a short time. • You feel dizzy or light-headed or like you are going to pass out. • You have a rapid heartbeat or trouble breathing. • You are coughing up or vomiting blood. • You have a rash or temperature greater than than 101.4°F (38.5°C). • Your doctor instructs you to go to a hospital's emergency department.

11. Prevention • Most nosebleeds occur during the winter in cold, dry climates. • If prone to nosebleeds use: • Humidifier in your home • Petroleum jelly (Vaseline) • Over-the-counter nasal lubricant spray • Saline nasal spray to keep your nasal passages moist. • Avoid picking your nose or blowing your nose too vigorously. • If the nosebleed is related to another medical condition, such as liver disease or a chronic sinus condition, follow your doctor’s instructions to keep that problem under control. • Stop smoking. Smoking contributes to nasal dryness and irritation.