Nose bleeding- bye nosb gotb blub (my nose got blood)

Nosebleeds, also known as epistaxis, are a frequent problem in children and adults in the dry environment of Montana. Although most episodes are a hassle, some can be downright scary. Not all epistaxis is promoted by dry air-- nose picking, nasal allergies, and nasal infections are all culprits. In older folks, high blood pressure, alcohol or other substance abuse, and poor blood coagulation (by drugs or disease) are also causes to consider.

Prevention of epistaxis seeks to correct whatever can be corrected- Dry nose? use Aquaphor; Nose picking? Stop!; High blood pressure? Control it.

When a nose bleed starts, the only goal is to stop it. There's a bunch of old, incorrect advice out there- so don't believe those old wives! Believe it or not, an older (but effective) treatment for a nose bleed was salt pork stuffed up the nose- it actually works- but outside the 1920s, who has salt pork just laying around the kitchen!? The guide (below) was designed from my experience in stopping nose bleeds over the decades [assuming you have a nasal rinse bottle, oxymetazoline nasal spray (like Afrin), and cotton balls handy].

The nose can bleed a lot, so if you're ever feeling like you're going to pass out, better call 911.

1. Blow out nasal blood clots into the sink.

2. Do a nasal rinse with 105 F saline. Yes, hot saline! It is pro-hemostatic. Rinse 1 or 2 bottles.

3. Spray 3 sprays oxymetazoline nasal spray into each nostril.

4. Soak cotton balls in oxymetazoline nasal spray and stuff those in each of your nostrils regardless of the side that's bleeding. Option: Use Nampons (in major stores) instead of cotton balls. Nampons are expandable nasal sponges you can cut to fit your nose then hydrate with oxymetazoline. Be sure to leave a tag end to allow removal.

5. Tilt your head forwards.

6. Pinch the wiggly part of your nose as hard as you can stand for 10 minutes.

7. Release pinching pressure. If you're still bleeding, you need to call 911 or have a friend take you to the Emergency Department.

8. Alternatively, if it's during business hours, call our office and we can take care of you.

   
   

The plan (above) also applies to patients bleeding after nasal surgery.

In evaluating kids or adults with a history of epistaxis, our nasal examination usually entails a nasal scope (nasal endoscopy) to rule out masses or other causes hidden deeply within the nasal cavity.

Commonly, prominent blood vessels on the septum (nasal center wall) are the source for recurrent epistaxis and are easily cauterized in the office with silver nitrate- all ages tolerate this easily after some topical nasal numbing medicine.

For patients needing more advanced care, we can place both dissolving and non-dissolving nasal packing as well as provide endoscopic septoplasty and advanced endoscopic techniques such as endoscopic sphenopalatine artery ligation (ESPAL) in the OR to get to the heart of the problem.

Don't live your life fearing your next bleed- we can help you take control!