Definition

Bleeding from inside the nose.

Etiology

•           Frequency is greatest in the autumn and winter months.

•           NSAIDS intake

•           Alcohol intake increases the bleeding time

•           Hypertension

•           Septal abnormalities

•           Bleeding and Coagulation disorders

•           Trauma

•           Post surgery       -

•           Warfarin

•           Liver and Kidney disorders

•           Tumour

Clinical diagnosis

Bleeding from nose

Management

A.  Precautions

•           Avoid hard nose blowing or sneezing.

•           Sneeze with the mouth open.

•           Do not use nasal digital manipulation.

•           Avoid aspirin and other NSAIDs.

B.  Instructions for self-treatment for minor epistaxis:

•           Apply firm digital pressure for 5-10 minutes by pinching the nose.

•           Use an ice pack

•           Practice deep, relaxed breathing.

•           Use a topical vasoconstrictor.

C.  Etamsylate       250-500mg P0 q4-6hour

Can be given by Oral & IV/IM route also.

D.  Cauterisation

Useful in anterior epistaxis when bleeding point has been located.

Bleeding point cauterised with a bead of silver nitrate or coagulated with electrocautery.

E.  Anterior and posterior nasal packing