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Nose Bleeding/Epistaxis

Epistaxis is defined as bleeding from the nostril, nasal cavity or nasopharynx. Nosebleeds are due  to the bursting of a blood vessels within the nose. This may be spontaneous or caused by trauma. Nosebleeds are rarely life threatening and usually stop on their own.

They can be divided into 2 categories, based on the site of bleeding

Anterior ( in the front of the nose )

Posterior ( in the back of the nose )

Approximately 60% of the population will be affected by Epistaxis at some point in time, with 6% requiring professional medical attention.


Nosebleeds can be caused by trauma to the outside of the nose from a blow to the face, or trauma to the inside of the nose from nose picking.      Other conditions that predispose a person to nosebleeds include:

  • Exposure to warm, dry air for prolonged periods of time,
  • Nasal and sinus infections,
  • Allergicrhinitis
  • Nasal foreign body (object stuck in the nose )
  • Vigorous nose blowing,
  • Nasal surgery,
  • Deviated or perforated nasal septum
  • Cocaine

First aid recommendations below:

  1. Pinch all the soft parts of the nose together between your thumb and index finger.
  2. Press firmly toward the face – compressing the pinched parts of the nose against the bones of the face.
  3. Lean forward slightly with the head tilted forward. Leaning back or tilting the head back allows the blood to run back into your sinuses and throat and can cause gagging or inhaling the blood.
  4. Hold the nose for at least five minutes. Repeat as necessary until the nose has stopped bleeding.
  5. Sit quietly, keeping the head higher than the level of the heart. Do not lay flat or put your head between your legs.
  6. Apply ice (wrapped in a towel) to nose and cheeks.
  7. Go home and rest with head elevated at 30 to 45 degrees.
  8. Do not blow your nose or put anything into it. If you have to sneeze, open your mouth so that the air will escape out the mouth and not through the nose.
  9. Do not strain during bowel movements. Use a stool softener (for example, Colace).
  10. Do not strain or bend down to lift anything heavy.
  11. Try to keep your head higher than the level of your heart.
  12. Do not smoke.
  13. Stay on a soft, cool diet. No hot liquids for at least 24 hours.
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