Nasal bleed

  •  The nose is an extremely vascular structure and bleeds from the nasal cavity are common.
  •  Can occur in adults and children.

    There are two types of nose bleeds:

  •  Anterior: occurs when the nasal mucosa or vessels in the anterior part of the nose are injured.
  •  Posterior: bleed occurring in the deeper part of the nose and the patient presents with a bleed from the oral cavity as it drips into the throat.

    Causes of nasal bleed:

  •  Finger nail trauma (nose picking)
  •  Trauma to the nose
  •  Deviated nasal septum or spur
  •  Foreign body in the nose
  •  Frequent/ aggressive nose blowing/ frequent sneezing
  •  Bleeding disorder
  •  Blood clotting disorders
  •  Hypertension
  • Management:

  •  A Reassuring the patient and vitals checked
  •  A posterior nasal bleed may be more difficult to manage and cause more discomfort to the patient as it drips into the throat.
  •  Decongestant nasal drops may be instilled and the nose pinched for 10 minutes, while sitting bent forwards and breathing softly from the mouth. Applying cold compresses on the nose may cause vessels in the nose to shrink and therefore stop the bleed.
  • Here is no single test to determine the cause of a nasal bleed. Some of the tests are done to identify and manage the bleed are:

  •  Blood tests to evaluated the clotting power of your blood
  •  The cause/site of bleed may be identified with the help of a diagnostic nasal endoscopy.
  •  Imaging such as Xray or CT if there is history of trauma
  •  In case a foreign body is identified, removal is attempted.
  •  Nasal packing may be needed if the bleed is continuous.
  •  Site of bleed is identified and cauterised with silver nitrate or TCA.