Treatments For Nosebleed (Epistaxis)
Whether you’re suffering from an acute or chronic case of nosebleeds, it’s always good to know what options are available to you, how to prevent the problem, and how to deal with the pain. Here, you’ll find a list of treatments that can help.
Anterior bleeds
Identifying the source of the epistaxis is important to the successful treatment of nosebleed epistaxis. In the most common form of epistaxis, anterior nose bleeds, the underlying cause is usually an irritating blood vessel that can be cured by pressure and/or cauterization. However, there are a variety of other local and systemic causes of epistaxis.
In patients with idiopathic/multifactorial epistaxis, coagulation studies may be performed. These tests can be requested for active bleeding, but should not be performed routinely for other patients. In addition to coagulation studies, a cross-match and complete blood cell count can also be requested. In addition, the surgeon should consider ordering clotting studies if bleeding persists or occurs repeatedly.
The most common source of anterior nose bleeds is the Kiesselbach’s plexus on the anterior nasal septum. The plexus is located 1.5 cm posterior to the mucocutaneous junction. This plexus is comprised of numerous small blood vessels, or capillaries, that have little structural support. The majority of bleeds can be stopped with external pressure and nasal endoscopy. However, in patients with chronic epistaxis, a vasoconstrictor may be required. A cotton ball soaked in lidocaine 1% and epinephrine 1:1,000 can be placed into the greater palatine foramen to slow the flow of posterior blood to the nose.
Nasal endoscopy can also be used to identify the source of bleeding. In most cases, bleeding can be stopped by applying pressure, but if the bleeding persists, the surgeon may perform cauterization. This procedure seals the irritated blood vessel and can be performed in an operating room. It can be performed with similar outcomes to electrocautery. Chemical cauterization is a less invasive procedure, but it has similar complications. It can be performed safely in the clinic.
Other causes of epistaxis include local injuries, such as frank facial trauma. If the cause of the epistaxis is trauma, the patient should be seen by an otolaryngologist. In patients who have severe hypertension or coagulopathy, admission to the hospital may be necessary.
Anterior nose bleeds can be treated with the use of nasal tampons or pledgets. When packing the nose, make sure to use enough gauze. If not, it will only serve as a plug in the anterior nares. Also, make sure to pack the anterior nasal cavity with antibiotic ointment to prevent toxic shock syndrome.
In cases of anterior epistaxis, a chemical cauterization can be performed. A silver nitrate cauterization can be safely performed in the clinic, but it should be done only after several seconds to seal the wound. If the bleeding is profuse, a Yankauer suction should be performed. In patients with recurrent epistaxis, the use of digital pressure may be helpful. Apply pressure to the inferior nasal sidewall and the lower lateral cartilages. When applying pressure, the patient should lean forward to prevent swallowing the blood.
Treatment options
Depending on the type of nosebleed, treatment options include first aid measures, self-treatment, or more extensive procedures in an emergency room or hospital. Approximately 60% of the population will experience nosebleeds at least once in their lifetime. These bleeds can be infrequent, moderate, or severe. It is important to seek immediate medical care. Severe bleeds may lead to a life-threatening condition. Fortunately, the majority of bleeds are short-lived, limited in severity, and can be prevented with simple first-aid measures.
The initial step in assessing and treating a nosebleed is to ensure that there is no airway obstruction and that the patient is stable. Once this is determined, the otolaryngologist will examine the nose with a speculum and various light sources. This will allow the physician to identify the source of the bleeding. If the bleed is located in the anterior nasal cavity, the physician can apply a topical solution of phenylephrine to the nose.
Alternatively, the physician can apply a vasoconstrictor to constrict the blood vessels. Depending on the severity of the bleeding, the physician may use a topical or local anesthetic to ensure that the patient does not feel pain during the procedure.
The physician may also remove clots that have formed inside the nasal cavity. If the bleeding is located in the anterior part of the nose, the physician may use forceps to remove the clot. If the bleeding is located in the posterior nasal cavity, the physician may use a nasal pack to stop the bleeding. If the clot is large, the physician may use large bore Frazier suction.
In some cases, the physician may need to order blood tests to rule out a bleeding disorder. Some conditions may contribute to frequent or chronic epistaxis, such as hemophilia, von Willebrand disease, and hemorrhagic telangiectasia syndrome. Other conditions may be associated with the occurrence of epistaxes, such as pregnancy or nonsteroidal anti-inflammatory drugs.
The physician should also ask the patient about his or her medical history, including any medications or comorbid conditions. If the patient has a history of recurring epistaxis, the physician may order an endoscopy to identify the source of the bleeding.
The physician may also order x-rays to check for abnormalities in the blood vessels. The physician may also use topical medications to constrict blood vessels or may remove the clots that have formed inside the nose. If the bleeding is due to an overdose of anticoagulants, the physician may adjust the medication. If the bleeding is not able to be controlled with these treatments, the physician may consider surgical or invasive methods.
Some otolaryngologists may be able to control the bleeding using cauterization. This may involve sealing the bleeding blood vessels using silver nitrate or other chemicals. A thin nasal endoscope can be used to perform the procedure. Alternatively, the physician may perform the procedure in an operating room (OR) setting.
Prevention
During the winter months, your nose may get irritated because the nasal mucosa becomes dry. To combat the problem, you can use a saline spray several times a day. You can also apply Vaseline or Ayr gel to the mucosa.
You can also apply a cold compress on the affected area. This can help constrict blood vessels and slow down the bleeding. It should be applied for no more than 10 minutes and you should avoid applying the ice directly on the skin.
There are also topical vasoconstrictive nasal sprays that can help you stop a nosebleed. These sprays contain oxymetazoline or epinephrine. These sprays are helpful for both anterior and posterior epistaxis.
Another way to prevent a nosebleed is to not blow your nose. The process of blowing can clear blood clots from the nostrils, but it can also increase the amount of bleeding. If you have a nosebleed, it is best to sit up straight and avoid straining your neck. This can prevent the blood from reaching your throat, which can cause vomiting.
In the event that your nosebleed is severe, it is best to seek medical attention. Depending on the severity of your bleeding, it may be necessary to have a physician cauterize the blood vessel to stop it. This procedure is painful and should be performed only in the most extreme cases.
You can also try applying a topical saline ointment on the nasal mucosa. You should not apply this treatment to the entire nose, but you should focus on the affected areas. These products are available over the counter and can help you stop a nosebleed. You can also use a humidifier in your home to prevent the dryness of the nasal mucosa.
Another tip to prevent a nosebleed is to avoid lifting heavy objects. If you have a nosebleed, you should avoid sitting in bed or lying down. You should also avoid bending down or tilting your head back, which can cause vomiting.
While you are waiting for medical attention, try using an ice pack on the affected area. This is an effective method of constricting blood vessels and lowering the blood flow to the area. You should not place the ice directly on the skin, but instead, wrap it in a cloth.
You should also wear protective headgear when doing activities that could hurt the nose. Some activities that could cause bleeding include carrying heavy objects, playing contact sports, and blowing your nose. In addition, you should avoid lying down for a period of at least 24 hours.
Another way to prevent a nosebleed at the home is to keep fingernails short and avoid picking at your nose. This is because sharp nails can poke your nasal membranes and cause damage. You should also avoid using alcohol or drugs to treat your nosebleed.
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Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
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