Nosebleeds

Nosebleeds (epistaxis) can be a stressful event. They can occur at any age but are most common in children between the ages of 2-10 years old and adults from ages 50-80. Fortunately, most nosebleeds are self-limiting and benign, and can typically be managed at home. Frequent or heavy nosebleeds or those associated with a blow to the head or a fall however, can indicate a need to consult with an ENT doctor for a thorough examination of the nose.

Nosebleeds can have many causes, which may include direct trauma to the nose, allergies and upper respiratory infections, exposure to warm, dry air, vigorous nose blowing, clotting disorders, medications, or tumors.

Managing Nosebleeds at Home

Infrequent, non-severe nosebleeds can usually be managed at home.  It is important to stay calm while handling the bleeding because an agitated patient may bleed more than one who is calm. Nasal decongestant sprays, such as "Afrin" can be sprayed into the nose, or a small cotton ball can be saturated with the decongestant spray.  This cotton ball should be placed in the front portion of the nose and the nostrils can be gently pinched for 5 minutes, while the patient leans forward to prevent blood from going down the throat.  After several minutes, the cotton can be gently removed to prevent dislodging the clot that may have formed.  If bleeding persists, seek medical attention.

Professional Care for Nosebleeds

If a patient is actively bleeding and is unable to stop the bleeding at home, the patient should seek help at an emergency room. Frequently, an ER physician will "pack" the nose to stop the bleeding. If nosebleed episodes continue, however, it is important to consult an otolaryngologist who will carefully examine the nose prior to making a treatment recommendation. A common treatment for nosebleeds is nasal cautery. Cautery is a technique in which the blood vessel is treated with either silver nitrate or an electric current. Silver nitrate treatment is performed as an office procedure, usually used for smaller vessels that are easily visible and accessible. For larger bleeding vessels, vessels farther back in the nose, or for recurrent episodes of bleeding which are non-responsive to silver nitrate treatment, electrocautery  may be recommended. The size and location of the bleeding vessel(s) will determine if the electrocautery procedure can be done in the office or as an out-patient procedure under general anesthesia.  More info.