Nosebleed or epistaxis is bleeding from the nose due to damage to the tiny and delicate blood vessels. Nosebleeds can affect all ages, but are twice as common in children as in adults.
There are two types of nosebleeds: anterior and posterior. Anterior nosebleeds are more common and occur from the tip of the septum, which is the central partition that divides the nasal cavity and the external nose into right and left halves. The blood vessels in the septum are fairly delicate and it does not require much force to rupture one and cause nosebleed. This form of nosebleed is not serious and is quite easy to control. Posterior nosebleeds occur very rarely, from the higher part of the septum or deeper in the nose, are harder to control and require medical attention.
Nosebleeds occur more frequently in winters when infections are common or in extreme hot conditions. Sometimes bleeding from the nose may occur in patients who have suffered a head injury. In these cases, prompt medical advice must be sought.
What are the causes?
There are several possible causes of a nosebleed. These include:
Excessive nose picking
Frequent and forceful nose blowing or sneezing during cold or allergies
Dry air which can be a problem in cold climate due to which the mucous membrane or lining in the nose becomes dry, cracked and prone to bleeding
Certain medication such as nose sprays can cause nosebleeds as a side effect
Injury to the nose
Infection in the nose
Recurrent nosebleeds may be a symptom of any other condition such as high blood pressure, bleeding disorder or a tumour of the nose
How is it diagnosed?
The diagnosis is made considering the medical history and observing the symptoms. The doctor may examine the nose using special instruments. In serious and recurrent cases X-ray of the nose may be required to make the diagnosis.
What is the treatment?
The treatment of the nosebleed depends on the cause and severity. In case of a mild nosebleed, pinching the nose for about five minutes may help to stop the bleeding. A person who has repeated nose bleeds or a nosebleed that does not stop needs further treatment. Topical anaesthesia (applying the medicine to numb the required area directly on its surface) and medicine to shrink blood vessels may be given. If the doctor can see the broken blood vessel by examination, it can be sealed by applying heat or electrical probe to stop the bleeding.
If the source of bleeding cannot be seen, a special tube is inserted into the nose to see it better and the bloodvessel can be sealed the tube if needed. If the cause is a bleeding or clotting disorder, medication can treat it. If the cause is a tumour, may be required surgery to remove the tumour.
What first aid can be provided?
Following first aid steps should be considered to provide immediate care to the patient:
Make the person sit in a comfortable position
Check to see if there is any object in the patient’s nose and remove it if necessary
Pinch the nose firmly for 5 to 10 minutes without releasing
Release the nostrils slowly and avoid touching or blowing the nose