Nosebleeds: When It’s Time to Get Medical Attention

Doctors call it epistaxis; the rest of us call it a nosebleed.

Most adults have experienced a nosebleed at some point in their lives, and the nosebleeds are usually isolated incidents that stop on their own.

But for some—about 15% of people—nosebleeds are a regular occurrence. “Frequent nosebleeds are a reason to see a primary care doctor or an ENT (an ear, nose, and throat) specialist,” says David A. Gudis, MD, associate professor of otolaryngology/head & neck surgery at Columbia University Vagelos College of Physicians & Surgeons and chief of the Division of Rhinology & Anterior Skull Base Surgery at Columbia University Irving Medical Center/NewYork-Presbyterian Hospital.

“When nosebleeds are frequent, they can really get in the way of daily activities and be a significant hindrance to having a normal and healthy quality of life.”

Recurrent nosebleeds can often be managed by simply holding pressure on the nose, but in some cases, medical or surgical intervention is necessary. In rare cases, Gudis says, frequent nosebleeds may be a sign of a more significant health issue, so it’s important to see a specialist to determine the underlying cause of the problem.

And some nosebleeds involve such a significant amount of blood loss that they can result in airway obstruction or a life-threatening emergency.

We spoke with Gudis, who recently published an article with a video in the New England Journal of Medicine discussing the proper evaluation and treatment of recurrent nosebleeds. Here’s what you need to know:

Blame your Kiesselbach’s plexus.

Nosebleeds usually come from the area of the front of the nasal septum known as the Kiesselbach’s plexus, where a number of arterial branches converge. The vessels keep the area well supplied with blood, which is critical for the health of the sinuses. But it can result in frequent nosebleeds.

In adults, turbulent airflow can lead to nosebleeds.

Especially in the case of a deviated nasal septum, the inner part of the nose can be a place of turbulent airflow. “Even though it’s essentially unnoticeable to the average person, over time it can cause trauma to the mucous membrane that covers Kiesselbach’s plexus and cause recurrent nosebleeds,” Gudis says. Cold, dry air can also be a trigger.

Individuals who take aspirin to prevent heart attacks or have a platelet condition that impairs their ability to form blood clots are also more likely to have recurrent nosebleeds.

“I often see patients who are taking some kind of antiplatelet or anticoagulant medication,” Gudis says. “It’s easier for us to manage nosebleeds than to manage a stroke or a heart attack, so I would rather treat their nosebleeds aggressively so that patients can stay on their anticoagulant or antiplatelet medications.”

In kids, fingers are often the culprit.

Kiesselbach’s plexus also happens to be where the fingers of little kids have easy access.

“We refer to that medically as digital trauma,” Gudis says. “Basically, you’ve poked your nose with your finger too much, and that’s a common way the region becomes traumatized. ”

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See an ear, nose, and throat specialist if nosebleeds are very frequent.

What constitutes very frequent nosebleeds? “I would really defer to the patient,” Gudis says. “If nosebleeds are troublesome for the patient, upsetting, or interfering with daily activities, it’s worth seeing a specialist.”

A specialist can rule out a few diagnoses by examination or taking a history. One condition, called hereditary hemorrhagic telangiectasia, or HHT, is a genetic condition that causes abnormal blood vessel formation.

“These aren’t the kind of nosebleeds that most people have experienced before,” Gudis says. “These people can lose a pint of blood every time they take a really hot shower or bend over to tie their shoes.” The most frequent symptom of HHT is severe nosebleeds, but the condition also causes abnormal blood vessels in other parts of the body. “Even in the absence of a family history, spontaneous mutations can cause this condition, so it’s a diagnosis that needs to be considered in patients who have frequent or recurrent epistaxis. ”

Other things to consider are tumors, both benign and malignant, that can form in the nose or the sinuses.

If you lose about a cup of blood, seek immediate medical attention.

If a nosebleed just gets a few tissues or paper towels wet and then eventually stops, “that might feel like a lot of blood,” Gudis says, “but in terms of the body’s volume of blood, that is not really a severe nosebleed.”

Gudis tells patients that if the nosebleed could fill a cup with blood, that’s a severe nosebleed that needs attention. “If it’s like a leaky faucet dripping from the nose, nothing is stopping it, medical attention is required,” he says. “That might mean a trip to the emergency room or to a primary care doctor’s office.

“If a nosebleed is severe enough that it can fill up a cup with blood, then we are in the territory of something where urgent medical attention is necessary. And occasionally these can turn into life-threatening emergencies.”

Some home remedies work; others don’t.

If a patient has frequent nosebleeds, without any other concerning signs or symptoms, topical moisturizing agents for the nose—nasal saline gel spray or a little bit of petroleum jelly in the front of the nose—can protect the lining of the nose and minimize nosebleeds. Humidifiers in the bedroom or office can be very helpful for preventing cold dry air from irritating the lining of the nose.

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One common home remedy—putting a copper penny on the forehead or the nose—is probably not effective. “I’m not aware of any evidence that it helps,” Gudis says. “But sometimes cold things on the nose can constrict the blood vessels, so there is a little bit of truth to the concept. ”

If home remedies don’t work, silver nitrate cauterization can stop the bleeds.

For more troublesome cases, a quick application of silver nitrate in the doctor’s office can put a stop to the nosebleed.

“Silver nitrate is a chemical that’s been used in medicine for hundreds of years for lots of different purposes, and one thing it does very well is cause sclerosis of blood vessels,” Gudis says. “Essentially the silver ions in the silver nitrate are released around the blood vessels and cause an inflammatory reaction that creates scarring in the little arteries and veins in the nose. With the scars, blood doesn’t flow as much through the vessels, and they’re far less likely to bleed.”

The procedure is simple, quick, and very effective. But it does hurt briefly.

“I tell patients it’s going to sting. Usually it’s five or 10 minutes of discomfort and by the time the patient’s out the door, it doesn’t hurt anymore. I have had a handful of patients who have had pain for a couple days afterwards. That’s extremely rare and usually can be managed with over-the-counter pain relievers.”

The treatment does not disturb a patient’s sense of smell. “Every once in a while, patients will get a gray or silver discoloration to the front of their nostril that takes a day or two to go away,” Gudis says.

When to Worry About a Nosebleed: Causes, Treatment, and Prevention

Nosebleeds typically resolve on their own. But if they are severe or long lasting, they may be a sign of another health condition, such as internal bleeding, and require immediate medical care.

A nosebleed can be scary, especially when it happens to your child. But while nosebleeds can appear out of nowhere, most aren’t a serious cause for concern and usually resolve with home care.

The surface lining of your nose contains several blood vessels, and it only takes the slightest injury or irritation to trigger bleeding.

Nosebleeds are common in children and adults, but some nosebleeds are more severe, in which case you’ll need to contact a doctor.

Here’s a look at common causes of nosebleeds, different ways to manage nosebleeds at home, as well as advice on when to talk with a doctor.

Most adults and children will have at least one nosebleed in their lives. In most cases, the bleeding will stop after a few minutes of self-care. Other times, though, nosebleeds have symptoms that may warrant a call or trip to a doctor.

When to contact a doctor for children

Understandably, a nosebleed in your child can invoke panic. Keep in mind, though, that nosebleeds are common in children. Of course, this doesn’t mean you should ignore every nosebleed.

Some nosebleeds are minor and you’ll notice blood dripping or running from your child’s nose. They might bleed from one nostril or both nostrils. Immediate home care helps stop the bleeding.

You should, however, talk with a doctor under the following circumstances:

• The nosebleed doesn’t stop after 20 minutes of direct pressure, especially if your child has an injury to their head or face. Serious injuries can affect the nose or skull.
• There’s an object stuck in your child’s nose.
• Your child has other symptoms such as dizziness, headache, tiredness, vomiting, or trouble breathing. This can indicate too much blood loss, or blood dripping down their throat.

When to contact a doctor for adults

Even if you’re used to having nosebleeds as an adult, you shouldn’t ignore certain symptoms.

• Similar to a child, call your doctor if a nosebleed doesn’t stop after 20 minutes of direct pressure, or if you lose a lot of blood (more than a cup).
• You should also talk with your doctor if you experience trouble breathing, gagging, or vomiting due to blood dripping down your throat.
• A serious injury to your head or that face causes a nosebleed also needs medical attention.
• If you’re bleeding from other parts of your body — ears or rectum, for example, this could indicate internal bleeding, blood clotting problems, or blood vessel disorders.

Both adults and children should also be examined by a doctor for repeated, frequent nosebleeds, even minor ones. This can indicate an ongoing problem within the nose, perhaps nasal growths or nasal polyps.

Warning

If you’ve lost a lot of blood, don’t drive yourself to the emergency room. Instead, have a friend or relative drive you or call 911.

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Don’t panic if you or your child has a nosebleed. Several things can trigger minor bleeds. For example:

• picking the nose
• minor injury to the nose
• common cold, sinusitis, and allergies
• dry air
• blowing your nose too hard
• overuse of nasal decongestant sprays
• high altitudes
• chemical irritants
• blood-thinning medications
• deviated septum
• stress
• pregnancy

If you or your child has nosebleeds — perhaps due to sinusitis, allergies, or other known conditions — here are a few tips to decrease their frequency.

• Use saline nose drops as directed to keep your nasal passage moist.
• Use a humidifier when allergies or the common cold cause a nosebleed.
• Don’t blow your nose too hard.
• Try to quit smoking (smoking can dry and irritate your nasal passage).
• Trim your child’s fingernails and discourage nose picking.
• Wear protective face gear when playing certain sports.
• Open your mouth when sneezing to prevent injuring your blood vessels within your nose.

A nosebleed can look much worse than it actually is, but some bleeds are cause for concern.

Whether it happens to you or your child, take immediate steps to self-treat at home. Most nosebleeds will stop after a few minutes. But if the bleeding continues or you experience other symptoms, call or see a doctor.

Epistaxis, treatment in Krivoy Rog

January 23, 2023

What to do if the nose bleeds, how to stop the nosebleedBleeding from the nose after a blow or other traumatic impact is a completely understandable phenomenon. But what is the cause of nosebleeds without such an influence, and how to stop nosebleeds? Examination at the Mediton Clinic, search for the cause and purpose, treatment of nosebleeds in Krivoy Rog!

Epistakis or nasal bleeding is a fact that up to 60-70% of people experience during their lifetime. Up to a third of the population never experience such events, but among the patients who do, the causes are varied.

Epistaxis in humans is the outflow of blood from the nasal cavity due to damage to the vessels, which are quite numerous on the mucous membranes. 92-95% of people have anterior nosebleeds, the rest have posterior bleeding, when the middle and posterior parts of the nasal cavity are usually called the source of epistakis. Dangerous signals indicating an increased risk – the suddenness of nosebleeds, large blood loss, blood with foam or clots, and the inability to quickly stop the attack!

Bleeding from the nose, causes of epistakis

It is important to understand why the nose bleeds, further decisions and possible treatment of the pathological condition, if confirmed, will depend on this. Doctors divide the causes of nosebleeds in children and adults into two groups!

Local causes, dependence on processes directly inside the nasal cavity:
• Trauma to the nose, blows, as well as trauma to the mucosa, when scratched inside, damaged the nasal mucosa when instilled from a runny nose;
• Nosebleeds in children with foreign object damage;
• Epistaxis after surgery or treatment;
• Dystrophic changes in atrophic rhinitis;
• Drying of the mucosa after cold remedies, fissures and erosion;
• Inflammatory processes and hyperemia in rhinitis and sinusitis;
• Dry air, dirty air, allergic reactions;
• Effect of chemical irritants on the mucous membranes of the nose and respiratory tract;
• One of the causes of nosebleeds is neoplasms: angiomas, granulomas, papillomas.

Common causes, dependence on pathological conditions of organs and systems of the body, as well as external factors:
• Cardiovascular diseases: blood from the nose with pressure – hypertension, with atherosclerosis;
• Overheating, fever: epistaxis after sunstroke, with the development of infectious diseases;
• Reckless and uncontrolled use of medications: anticoagulants, hormonal therapy, vitamin complexes, inappropriate cold or allergy remedies;
• Blood diseases, blood clotting disorders, intoxication;
• Endocrine disorders, kidney and liver diseases;
• Hormonal changes in the body: nosebleeds in pregnant women, nosebleeds in adolescents;
• Physical overexertion, sudden changes in barometric pressure: swimming, air travel, mountain climbing!

Causes of nosebleeds The frequency of nosebleeds determines the risks, the level of attention to the problem, the need for urgent help. So, people have single nosebleeds, recurrent and habitual. Regardless of the frequency of cases, and even if you understand the reasons, make an appointment with a specialist. Blood from the nose in oncology, after removal of a neoplasm or hardware treatment of ENT organs, as well as nosebleeds with pressure, are also not the norm, except for situational and periodic cases. If you cannot stop the bleeding from the nose, and you also feel headache, dizziness, nausea and vomiting, thirst and general weakness, you see flies before your eyes and notice a rapid pulse, it is important to visit a medical facility, get first aid and undergo an examination!

How to stop a nosebleed, first aid

• You need to calm down, sit down and take a comfortable position, tilt your head slightly forward;
• It is advisable to breathe according to the following pattern – inhale through the nose and exhale through the mouth;
• Perform nasal packing. If blood flows through the left nostril, insert a cotton ball or swab into the left nostril; if through the right, into the right. With heavy bleeding from the nose – in both nostrils. Before the introduction of the tampon, it must be slightly moistened with warm water;
• It is easy to press the wings of the nose against the septum, apply a cold compress over the bridge of the nose;
• Expect bleeding to stop within 4-10 minutes;
• To remove swabs from the nose, moisten them with water using a pipette or syringe;
• If the bleeding cannot be stopped, call an ambulance!

Do not tilt your head back, lie down, blow your nose, smoke. All such actions can cause the opposite effect!

Diagnosis of nosebleeds at Mediton Clinic

If you experience frequent relapses, you should consult a doctor. We have a therapist, a family doctor and an otolaryngologist who can conduct an examination, clarify complaints, study the patient’s record and prescribe an instrumental examination and laboratory tests to confirm the diagnosis!

• A visual examination of the nasal cavities is carried out to determine the cause: scratches and other mucosal injuries, foreign objects, swelling, inflammation, etc. ;
• Collection of patient complaints: runny nose with blood, blood from the nose with clots, recurrent epistakis, often blood comes from the right nostril, or only from the left, whether the head hurts, nausea;
• Blood pressure is measured, breathing may be heard and additional examination in the doctor’s office;
• Complete blood count, coagulation test – coagulogram, prothrombin time test, hemostasis system examination;
• If you suspect pathological processes that provoke nosebleeds, analyzes and instrumental examination to confirm or refute them!

Frequent bleeding from the nose, treatment in Krivoy Rog

In our medical center, doctors will help you find answers to most questions: why the nose bleeds with pressure, first aid and prevention of epistakis, how to stop nosebleeds in a child, and what to do if the cases recur. Together we will find a solution, determine the disease and monitor the dynamics of therapy to prevent relapses!

It will also be important to constantly prevent nosebleeds in pregnant women, children, allergy sufferers working in hazardous industries, as well as people in an unusual, specific environment, for example, in the case of going to the mountains or the sea!

If you have injured the nasal septum and bleeding from one nostril, you have received a blow or scratched the mucous membrane inside, the nose bleeds without stopping or the cases are repeated, if you do not know how to stop the bleeding from the nose and are worried about a possible relapse, sign up for an examination at our medical center!

Nosebleed? Treatment in Krivoy Rog, Mediton Clinic Treatment of nosebleeds in Krivoy Rog, examination and finding out the cause, prevention! Consultation with an otolaryngologist, pediatrician and therapist, family doctor, if necessary, making an appointment with an infectious disease specialist and an allergist. Instrumental examination and laboratory tests. Phone Clinic Mediton: (098) 530-60-40!

We recommend to study:

Blood from the nose: examination by an ENT doctor see a doctor

The nose is one of the most vulnerable places. Most often, it is the nose that goes during a fight or a fall. In general, there are many reasons for bleeding.

Doctor’s consultation

You can get the consultation of the necessary specialist online in the Doctis 9 application0008

Laboratory

You can undergo a comprehensive examination of all major body systems

Just had plastic surgery? Too dry indoor air?
You work in very dusty conditions or in a chemical industry and do not use
means of protection? All of these are risk factors for nosebleeds.

What can cause nosebleeds?

Hypertensive patients know that nosebleeds can if blood pressure rises sharply.
“You are very lucky,” the doctors will say, because the body itself “took care” in this way
about reducing the pressure. If this had not happened, the outcome could have been much worse, and the nasal
bleeding helped prevent a stroke. And there is no need to rush to stop in such cases
bleeding, have the patient lose half a glass of blood. By the way, it is with the help of bloodletting that Zemstvo
doctors used to treat hypertension, because there were no such effective drugs as now, at that time.

But, of course, it is not worth relying only on the “grandfather” method today. We need to measure the pressure
give the patient an antihypertensive drug, and when some time has passed, sufficient for the medicine to
worked, – again check the level of blood pressure.

Sometimes nosebleeds occur in those who suffer from diseases of the internal organs –
liver, kidney, and hemophilia. People who are weakened, suffering from a lack of
vitamins in the body. Therefore, if the nose bleeds frequently, you need to apply for an appointment with
general practitioner
and get regular check-ups.

When is nosebleed more common: summer or winter?

In summer, there are usually more complaints of nosebleeds, especially in hot weather in the absence of rain,
when the nasal mucosa with many blood vessels located on its surface
suffers from dry air.

Can medications cause nosebleeds?

Yes, and this should be remembered by those who take anticoagulants – drugs that lower
blood clotting. If the doctor
prescribed them to you, you need to regularly do a coagulogram to check the indicators
blood clotting.

First aid for nosebleeds

First, let me tell you about what not to do. No need to lie down with your head thrown back. sit down
tilt your head forward, press the wings of the nose against the septum for a while. Breathe at this time
maybe by mouth. It is desirable to apply cold to the bridge of the nose. But do not forget that long-term exposure
cold is undesirable, because it won’t take long to catch a cold. The consequence of such excessive zeal at best
case, it can become a runny nose, and in the worst case, sinusitis.

If hydrogen peroxide is available, cotton swabs moistened with it can be placed in the nostrils.
tampons. Convenient to use and specially designed to stop nosebleeds hemostatic
sponge. You can buy it at a pharmacy.

It happens that a nosebleed is caused by a serious injury, then it is unlikely to cope with it on your own
succeed. Call an ambulance, and if it becomes necessary to take the victim to the hospital
on your own, make sure that his head is in an elevated position.

Which doctor should I contact if nosebleeds are frequent?

It is necessary to consult an otorhinolaryngologist.
The doctor can send for a general blood test with hemorrhagic
component. This will make it possible to determine several indicators at once, including finding out how much time
bleeding continues, what is the number of platelets, is blood clotting reduced.