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First aid measures for nosebleeds (epistaxis)

Sunday, 26 December 2010

Epistaxis or nosebleeds is defined as the bleeding from the nose and is classified as either anterior or posterior.
Anterior nosebleeds occur when the source of bleeding originates from Kiesselbach's plexus (Little's area) which is present in the anterior part of the nasal canal. Anterior epistaxis usually occurs in children and young adults.

(From Fleisher GR, Ludwig S: Textbook of Pediatric Emergency Medicine. Philadelphia, Lippincott, Williams & Wilkins, 1999.) 

However, posterior nosebleeds originates from the sphenopalatine artery which is present in the posterior part of the nasal canal. Posterior epistaxis usually presents in old individuals.

First aid measures for controlling epistaxis:
In most cases, the bleeding will be from Little's area. You must sit down and lean slightly forwards. You must breath through your mouth.
Pinch the nose so that the nostrils are closed between your thumb and forefinger for 10 minutes. Apply cold compresses to the bridge of the nose, if possible. Besides, you can suck on ice to achieve the same result. 
This is done so that vasoconstriction of vessels is obtained which will reduce the amount of blood supplying the nose.

If epistaxis didn't stop, you must contact your doctor immediately. He/she will put a cotton gauze with medication into the nostril. This is called nasal packing.

(From Auerbach P: Wilderness Medicine, 5th ed. St. Louis, Mosby, 2006.)   

After bleeding ceases, cauterization can be done chemically with the use of silver nitrate. 

For posterior epistaxis, a posterior nasal pack is introduced by a special maneuver to stop the bleeding. 

Furthermore, if the above measures fail to control epistaxis then surgery will be the life-saving solution. 



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