Nosebleeds

Nosebleeds, also known as epistaxis, are a common but unpleasant occurrence.

If you have ever had a nosebleed you will know they are at best inconvenient and at worse frightening and life threatening.

Causes

Identifying the cause is important, but not always easy. Most nosebleeds originate from the front part of the nose, usually from the septum that separates the nasal passages, but some can originate from an area deeper than this, behind the nasal cavity where an artery sits. This type of nosebleed is far more dangerous and more often than not requires intervention from a nurse or doctor.

Identifying the cause can help you understand what area the bleeding is coming from, and then can direct what management is necessary.

Common causes of a nosebleed are; trauma, excessive blowing of the nose, coughing or violent vomitting, infection and foreign objects inserted into the nose (including illicit drugs).

There may be other causes, such as an underlying health conditions, recent ENT (Ear, Nose and Throat) surgery or some medications you may be taking.

Management

Treatment requires you to be sensible and responsible. It is important to stay calm and composed.

If you feel the bleed may come from the nose itself, or the front aspect of the nose structure, you should be able to manage it at home.

Positioned over a toilet or sink (to catch the drops of blood), hold your head forward. Pinch your nose, if possible, just under the bridge of the nose, gently but firmly. Apply ice to the back of the neck and, again if possible, to the forehead (a friend comes in handy here, but so does lots of tape or a bandage).

Holding the head forward will reduce the chance of you choking on the blood. It also reduces the chance of blood reaching your stomach, which in most people can induce nausea and vomiting.

Pinching the nose stems the flow, and allows a greater opportunity for the blood to clot.

Ice, or anything you can get hold of that's cold, with encourage the blood vessels to constrict, reducing the blood flow and hopefully stopping the nosebleed.

If, after 15 to 20 minutes, your nose is still actively bleeding, you should seek medical attention. A nosebleed rarely continues for this length of time unless it is originating from a deeper area behind your nose. Either phone an ambulance or make your way to your local Emergency Department, immediately.

At hospital, you may have your nose packed by a doctor, to stem the bleeding, and as a last result, you may be assessed as requiring surgery.

Prevention

If you experience regular nosebleeds and have identified the cause, this makes prevention easier. Avoidance of known triggers are advisable, but not always possible. Discuss with a healthcare professional management options for your triggers.

Also be aware that nosebleeds seem to be more common in the colder months and early in the morning. The reason for this is hard to understand but possibly could be a result of changes in the blood vessels and surrounding physiology in response to lower temperatures. Knowing this, keeping warm is a sensible precaution.

Some people also find a spray to moisten the lining of their nostrils, and using a humidifier at home, can help reduce the incidence of nosebleeds.

You should try not to take medicine, such as aspirin and warfarin, that can interfere with the blood's ability to clot.

If you know you are prone to having nosebleeds, try to avoid or be careful, when blowing your nose. Try never to pick, and NEVER push anything up your nostrils in an attempt to stop the bleeding. You may make it worse.

If you do have regular nosebleeds, you must see a doctor and have it investigated.