The nose, that incredible humidifier, filter and smeller. Often maligned, beaten up and bloodied.  Nosebleeds. At the very least they are frustrating. At most, they may require surgery.

The nose, that incredible humidifier, filter and smeller. Often maligned, beaten up and bloodied.  Nosebleeds. At the very least they are frustrating. At most, they may require surgery. What to do?



True or False

1 Place an ice bag on the back of the neck.

2. Tip your head backwards.

3. Pinch the nose below the nasal bone.



Any injury to the tiny blood vessels lining the nose will cause a bleed. Dry air, allergies, certain medicines and trauma all may cause nosebleeds. Of course, we have all experienced a whack to the nose which can bring the biggest among us to tears. Bleeding from trauma may indicate a fracture to the nasal bone.

Most often, the area of bleeding is in the front of the nose at Kiesselbach’s plexus where vessels are very superficial and vulnerable to injury. These are easier to see and manage. Bleeds which occur in the back of the nose are much more difficult to see and stop. These tend to drip blood down the back of the throat which can be very uncomfortable. 

There are various techniques to stop nose bleeds. For those occurring in the front, simply pinching the nose below the nasal bone for 4-5 minutes may be all that is needed. Items placed inside the nose may dislodge a clot or further injure the fragile lining of the nose and is discouraged. Nasal decongestant sprays (Afrin or Neo-sinephrine) act to stop bleeding by constricting vessels. If after 15 or 20 minutes there is still bleeding, contact your physician. 

A physician may place a cotton roll or gauze for compression over the bleeding site. A decongestant may also be applied. Cautery, actually sealing the blood vessels with heat, is used for persistent bleeds. In worst cases, a physician may need to cauterize through a small scope inserted into the nose.

There are many home remedies purported to stop nose bleeds. One is to place an ice bag on the back of the neck. This does nothing to stop the bleeding.

pping the head backwards also is ineffective and only causes blood to run through the nose and down the throat.  Sitting down and leaning forward will allow blood to drain forward which is more comfortable.

Those caring for athletes with nosebleeds should use medical gloves for protection and be prepared to properly dispose bloody materials. Bloody items left in a dugout or on the sidelines place others at risk for blood borne diseases. 

Only in the movies can a tough guy casually wipe away a bloody nose. Those who have suffered through the frustration of hours of bleeding don’t feel so tough. Recurrent, unexplained nosebleeds merit a call to your physician. 



Answers

1. F 2. F  3. T