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January 21, 2016

What is a nosebleed or “epistaxis”?

A nosebleed is epistaxis also called bleeding from the nasal passages, usually flowing through the nostrils but sometimes in the pharynx. Epistaxis is often mild; however, certain medical or traumatic situations may be responsible for severe bleeding.

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The lining of the nose is fragile and bleeds easily but briefly, during a cold or shock on the nose for example. The blood flow is prior (nostrils) or posterior (towards the groove), or both at once.

The epistaxis, is commonly called “nosebleed”, without exception, a benign condition.

Why nose bleeds?

The nasal mucosa (membrane lining the nasal cavities) is irrigated by an extensive network of blood vessels that are used to warm and moisten inhaled air. Epistaxis is due to injury of these vessels.

The most common causes are:

  • Inflammation of the lining of the nose (during an infectious rhinitis or in case of allergy, for example);
  • An air drought (e.g. in very heated rooms in winter or in a very dry climate);
  • Scraping of the nasal mucosa (common in children in case of dryness or crusty nasal mucus);
  • Trauma of the nose (e.g. after putting a small object into a nostril, more common in children);

DO YOU KNOW ?

Nosebleed occurs frequently forward nose.

The front of the nose is more prone to bleeding than posterior. This is due to the presence of the so-called “dense vascular spot”, a region which is rich in blood vessels. This area is easily visible and accessible to the examination as a treatment.

What to do in case of having nosebleed?

Before a nosebleed or “epitasis” happens, what to do depends on the severity of the symptoms observed. To assess this, we consider the abundance of bleeding and the context in which it appears. Depending on circumstances, it must then contact emergency services or make yourself a few simple gestures.

Gestures to oneself

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You can treat yourself when having nosebleed at home if it is not serious. A mild epistaxis can be recognized by the following signs:

  • Hemorrhage (bleeding) occurs without apparent cause, usually at one nostril;
  • Blood flow is scarce and drip;
  • Your general health condition is good: you do not notice any alarming sign.

In this case, you can achieve compression to stop bleeding:

  • Blow your nose very gently (and only once) to remove the larger blood clots. They could in fact prevent you from properly applying pressure to your nose.
  • Sit back and slightly tilt your head forward, look at the ground and breathe through the mouth. If you could turn your head back, blood could enter your throat and if you avail, you may have nausea.
  • Place your thumb and forefinger just below the bony part of your nose, then pinch your nostrils. And hold for 10 minutes (use a watch to fully respect the time). Know that the normal clotting is at least 7 minutes. That is why it is important not to interrupt compression, even saw the bleeding has stopped.

Most nosebleeds stop with this method. However, if you bleed more, repeat this action for 10 minutes.

You can also apply ice on the middle of your face, above the nose. This reduces bleeding by causing blood vessels to constrict (tighten it under the effect of cold).

Once you have stopped bleeding:

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  • Try not to blow your nose for at least 12 hours, and then do it gently. Furthermore, cough or sneeze with opened mouth to avoid a new episode of nasal bleeding;
  • Do not rub your nose, do not attempt to clean your nostrils or insert anything;
  • Moisten the air in your home to prevent the formation of nasal crusts, and do not scratch those that can form;

If the nosebleed lasts for a long time or has been difficult to stop, raise your head to sleep for the next few days;

If you are taking aspirin or other non-steroidal anti-inflammatory drug (NSAID), ask your physician: he can tell you if you can stop the treatment.

Emergency situations

You must call emergency medical services if the person has one or more of these factors:

  • A significant blood flow occurs through both nostrils and the throat;
  • A blood flow associated with other symptoms: pallor, malaise, sweating, rapid heartbeat, anxiety, agitation, rapid heart rate raising fears of a shock, etc .. This can be the case of a senior health fragile, sufferance from such chronic anemia or cardiovascular disease (e.g. angina);
  • A risk of bleeding due to a bleeding disorder (hemophilia) or taking anticoagulants or ant platelet agent;
  • Severe trauma

Until help arrives, do a compression to reduce bleeding, except in cases of major trauma of the face.

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