Epistaxis, or a nosebleed, is the common event of blood draining from the nose. Most people have at least one nosebleed during their lifetime. They are twice as common in children compared with adults. Most stop with direct pressure on the nose, but some may need medical care.
A break in blood vessels in the nose, such as from an injury (blow to the nose) causes a nosebleed. Other causes include chemicals, infections, abnormal blood vessels in the nose, and diseases such as high blood pressure or bleeding disorders. The most common cause is dry nasal passages from dry air, especially in winter.
Symptoms include bleeding from one or both nostrils and bleeding down the back of the throat with spitting, coughing, or vomiting of blood.
Prolonged or recurrent nosebleeds may cause anemia.
After a big nosebleed, dark or tarry bowel movements mean that a large amount of blood was swallowed.
The health care provider will diagnose the nosebleed from a physical examination. Blood work may be done if a large amount of blood was lost or a blood disorder may be causing the nosebleed.
The first treatment is direct pressure. Grasp the nose firmly between the thumb and forefinger and squeeze it for 10 to 30 minutes without stopping.
Putting an ice pack on the neck or bridge of the nose may help slow blood flow. Leaning forward to spit out blood instead of letting it run down the throat and be swallowed may help prevent vomiting. Using salt water nasal sprays and humidifying the air may help dryness.
Sometimes, packing the nose with absorbent gauze may be needed. The health care provider may also cauterize the bleeding site. Some elderly people can have a slowed pulse rate or blood pressure abnormalities from packing and may in some cases need hospitalization.
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