Nosebleeds (Epistaxis)

What causes nosebleeds? The nose is prone to bleeding because it has many blood vessels in it to help warm and humidify the air you breathe. These vessels lie close to the surface, making them easy to injury. The most common causes are dryness and nose picking (nose picking occurs more often when mucus in the nose is dry and crusty). If you have a deviated septum, this can predispose you to nosebleeds as well as it makes the airflow more ‘turbulent’ and drying. Other less common causes include injuries, inflammation from colds or allergies, and high blood pressure. Medications that thin your blood (like Aspirin, warfarin, or Plavix) can also cause heavier nosebleeds that are more difficult to stop since your blood can’t clot as well. What should I do when I get a nosebleed?
Sit down and lean forward. If you lean back, you may swallow blood which can irritate your stomach, causing nausea, vomiting, and diarrhea. Pinch the soft part of your nose closing your nostrils (not the hard bony part) and hold pressure for 10 minutes without peaking. If after 10 minutes, you’re still bleeding, hold pressure for another 10 minutes. You should seek medical help if bleeding does not stop after 20 minutes.
  • Do not stuff your nose with tissue to try to stop the nosebleed.
  • Passing blood clots is normal, it means your body is functioning properly and trying to coagulate your blood to stop the bleeding.
  • Another option is soaking a cotton ball in a nasal decongestant (like Otrivin or Afrin) and placing it in the front part of your nose of the affected side and then holding pressure. WARNING: These topical decongestant sprays should not be used over a long period of time. Doing so can increase the chance of a nosebleed.
  • Keep your head higher than your heart.
  • After the bleeding stops, DO NOT bend over, strain and/or lift anything heavy. DO NOT blow or rub your nose for several days.
  • How to prevent nosebleeds
  • Run a humidifier in your bedroom at night. You can also add a humidifier to your furnace.
  • Apply water-soluble nasal gels or ointments to your nostrils at bedtime and up to three times per day. They are available at pharmacies and include Vaseline, Neilmed Nasogel, Rhinaris Nasal Gel and Salinex Nasal Lubricant.
  • Sneeze with your mouth open and gently blow your nose one nostril at a time.
  • Keep your child’s fingernails short.
Nasal CauteryIt’s important to keep note on which side your nosebleeds are occurring. If they are frequent despite trying the above prevention tips, you may benefit from having your nose cauterized. This works by sealing blood vessels and building up scar tissue to help prevent more bleeding. Cautery is done using a chemical substance (silver nitrate) or heat energy (electrocautery). It may take several treatment sessions and only one side can be done at a time. Some increased bleeding is expected after the procedure for the first week or two.
AFTER THE PROCEDURE
  • Do not blow your nose for 3 days
  • Try to sneeze with your mouth open
  • Do not lift heavy items and avoid rigorous physical activity for a week
  • Apply a nasal gel or ointment three times a day for at least two weeks
  • Continue to keep track of which nostril is bleeding and for how long