First Aid

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Epistaxis (Nosebleed)

Epistaxis (Nosebleed) is a very common medical problem. It is usually caused by dry air that make blood drain out through nostrils. It can range from slight, which stops on their own and is not serious, to severe that requires immediate medical care.

Types:

Anterior nosebleed, which is the most common but not serious, occurs when the blood vessels in the front of the nose break and bleed.
Posterior nosebleed, which is less common but may be life-threatening due to losing a lot of blood, comes from the back of the nose near the throat.

Causes:

The lining of your nose contains many tiny blood vessels that lie close to the surface and are easily damaged.

Allergic rhinitis or common cold can cause nose infections.
Face or nose injuries like falls or bike accidents.
Nosebleeds rarely occur due to a serious problem, such as: bleeding disorders, vascular anomalies, or nasal tumors.
Medicines, for example, when taking blood thinners or anticoagulants (medications to prevent blood clots, such as: heparin or warfarin), thus one is more likely to have nosebleeds that cannot be stopped easily.

Causes of Frequent Nosebleeds:

Continuous exposure to dry air.
Long-term use of steroid nasal sprays, used to treat allergies, or nasal congestion.
Getting frequent common colds.

In some cases, frequent nosebleeds can be a sign of a bleeding disorder, while other symptoms are often found, such as: frequent bruising in different areas, and prolonged bleeding after minor injuries.

When to Seek Emergency Care?

If the bleeding is severe, causing breathing difficulty (dyspnoea).
If the person appears pale or fatigued.
If the bleeding still does not stop even after performing first aid.
If bleeding occurs after surgery close to the nose, or if the person has a nasal tumor.
If bleeding occurs after a facial injury.
If the person is taking anticoagulant medications, such as: aspirin, clopidogrel, warfarin, while nosebleeds do not stop.
If the nosebleeds occur frequently, or when bruises appear in the body or bleeding from other places, while current bleeding does not stop.
If the nosebleeds are severe, and the person suffers chest pain, or feels dizzy.

Nosebleeds First Aid:

Slightly bending forward while sitting or standing, avoiding lying down or head tilted back, as this will cause blood swallow and vomiting.
Holding the nose from the soft part (not the bone) in both ways, while avoiding pressure on only one side, even if the bleeding is on only one side.
Squeeze your nose closed for at least 5 minutes (for children) or 10 to 15 minutes (for adults). Do not release the pressure every so often to check whether the bleeding has stopped, except after the specified time has passed.
Cold compress or ice pack can be applied to the bridge of your nose. This may help the blood vessels constrict and slow the bleeding.
If you follow the steps outlined above, and your nose continues to bleed, repeat all the steps once more. Apply pressure for a total of at least 30 minutes. If you continue to bleed, seek emergency medical care.

Health Promotion and Clinical Education General Department

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