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30/Dec/2018

Nose Bleeds (Epistaxis)

It is cold season again, and noses become congested, start to run, bleed, and drip. The most concerning, of course, is when you see blood coming from the nose – or in doctor’s language, EPISTAXIS. Why do our noses start to bleed? In children the most common cause is at the tip of their fingers: scratching, poking, picking, prodding, itching, and bumping. In adults, it is often the same. We all have been guilty of that. Unfortunately, there are other factors that make our nose bleed much faster, easier, and more profusely.

What are the factors that lead to nose bleeds?

Dry air: the humidity level drops in the winter time, our noses are not used to the dry air.

Deviated nasal septum (the midline wall separating the right and left sides): the shape of the septum affects the flow of the air, which may create a “dry spot” as we breath in the air.

Fragile blood vessels: the small vessels break easily in people who bruise easily, have diabetes, or take high blood pressure pills.

Health-promoting products: Vitamin E, Aspirin, Ginkgo Biloba all promote bleeding from the nose.

Nasal sprays: Flonase, Nasonex, Nasacort.

Where is the most common site of nose bleeds? The area of the Nasal Septum (wall in between two nostrils) very close to the nostrils. It is easy to apply pressure by squeezing nostrils together.

What can I do to prevent nose bleeds?

Keeping the inside of the nose moist.

Use over-the-counter Aquaphor or Vaseline twice a day.  Apply a pea-size amount with Q-tip to the both nostrils. As an alternative, antibiotic ointments can be applied in the same fashion for a period of 7 days: Bactroban, Bacitracin or Polysporin (NOT Neosporin).

Use a humidifier in your bedroom (warm or cold, and make sure to clean it weekly to avoid mold formation).

Avoid picking at the scab or picking your nose in general.

Ask your doctor if you can stop Aspirin for a week. Stop nasal sprays, vitamins and supplements for one week.

How can I stop active bleeding from the nose?

Use these steps:

1.     Blow the blood out your nose (the blood clots have substances that interfere with clotting).

2.     Use WARM water to wash blood and clots out of your nose.

3.     Soak cotton ball (real cotton, not synthetic) with Afrin spray, place it inside the nose and pinch the “meat” of your nose (not the bone); applying pressure to the “meat” for 5 minutes is the key.

4.     Apply Vaseline to the nose after the bleeding stops.

 

When do I go to the closest ER or Urgent Centers?

If your blood pressure is not coming down.

If you can’t stop the bleeding despite all the efforts.

When do I see an ENT doctor?

If the nose bleeds stop but keep coming back, schedule an appointment with you Ear, Nose and Throat doctor for possible cauterization. DON’T wait too long, we need to see the area of bleeding when it is recent and fresh. That will help guide our treatment towards the area of the most concern.


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