Nosebleeds

Question 1

Another name for nosebleeds

Answer 1

Epistaxis

Question 2

Where does bleeding originate from in nosebleeds

Answer 2

Kiesselbach’s plexus, located in Little’s area. In the front of the nasal cavity that contains a lot of blood vessels

Question 3

Nosebleeds presentation

Answer 3

Common in young children and older adults. Can be triggered by:
Nose picking
Colds
Sinusitis
Vigorous nose-blowing
Trauma
Changes in weather
Coagulation disorders
Anticoagulation medication 
Snorting cocaine 
Tumours (e.g. squamous cell carcinoma)
Usually unilateral bleeding but from both indicated bleeding posteriorly in the nose (higher risk of aspiration of blood)

Question 4

Nosebleeds management

Answer 4

Usually resolve
Identify trigger
Sit up and tilt head forward
Squeeze soft part of nostrils together for 10-15mins
Spit out any blood in mouth rather than swallowing
If doesn’t resolve within 15mins, very severe bleeding or is bleeding rom both nostrils, hospital admission:
Nasal packing using nasal tampons or inflatable packs
Nasal cautery using silver nitrate sticks
After acute nosebleed, consider Naseptin nasal cream (chlorhexidine and neomycin) four times daily for 10 days to reduce crusting, inflammation and infection. Contraindicated in peanut or soya allergy.