Dr. Hazenfield -- Ear, Nose, and Throat Doctor in Hawaii

Nosebleeds (Epistaxis)

Hugh N. Hazenfield, M.D., F.A.C.S.

• Causes of nosebleeds:

   

  • Most nosebleeds (epistaxis) are mere nuisances.  However, some can be quite frightening, and a few are even life-threatening.

  • Physicians classify nosebleeds into two different types.

     

    • Anterior nosebleed:

      • Most nosebleeds begin in the lower part of the septum, the semi-rigid wall that separates the two nostrils of the nose.

       

      

       

      • The septum contains blood vessels that can be broken by being struck in the nose or by the edge of a fingernail or even a rolled-up tissue.

      • This type of nosebleed comes from the front of the nose and begins with a flow of blood out one nostril when the patient is sitting or standing.

       

    • Posterior nosebleed:

      • More rarely, a nosebleed can begin high and deep within the nose and flow down the back of the mouth and throat even if the patient is sitting or standing.  Posterior nosebleeds are more likely to occur in older people, persons with high blood pressure, and in cases of injury to the nose or face.

       

      

       

      • Posterior nosebleeds are often more severe and almost always require a physician's care.  Frequently, posterior nosebleeds are severe enough to require some form of packing.  This is a picture of an epistaxis balloon:

     

    

          Epistat ^®

• Treatment options for anterior nosebleeds:

   

  • Keep the person calm.  If he or she is upset, the bleeding may become worse.

  • Soak half of a cotton ball with Afrin^® or Neosynephrine^® nasal spray, place it in the nostril that is bleeding, and pinch the nose firmly for 10 minutes.

  • Keep the head elevated.

  • Apply ice in a sandwich bag wrapped in a cloth to the nose and cheeks.

  • If the nosebleed persists, see your doctor or go to the nearest emergency room.

  • After the bleeding stops:

    • Apply saline nasal gel to the nose three times a day for ten days.

    • Do not pick or blow nose.

    • Do not strain or bend down to lift anything heavy.

    • Keep head higher than the heart.

     

  • If re-bleeding occurs:

    • Attempt to clear nose of all blood clots by blowing it gently.

    • Spray nose four times in the bleeding nostril(s) with a decongestant spray such as Afrin^® or Neosynephrine^® or apply either medication on cotton.

    • Call your doctor if bleeding persists.

• What causes nosebleeds?

   

  • Allergies, infections, or dryness that cause itching and lead to picking of the nose.

  • Dry air, such as in heated houses, airplanes, or even in Las Vegas.

  • Vigorous nose blowing that ruptures superficial blood vessels in the elderly and in the young.

  • Manipulating the end of the nose.

  • A deviated septum (crooked middle structure of nose)

  • Hypertension (high blood pressure).

  • Clotting disorders that run in families or are due to medications.

  • Fractures of the nose or of the base of the skull that can cause bleeding and should be regarded seriously when the bleeding follows a head injury.

  • Rarely, tumors (both malignant and nonmalignant) have to be considered, particularly in the older patient or in smokers.

 

 

My offices are in the following convenient locations:

• Aiea (also serving Honolulu & Waipahu)

• Wahiawa (also serving Mililani & the North Shore)

For appointments call:  (808) 622-2626

 

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You deserve the best of care. When seeking an otolaryngologist, be certain that he or she is Board Certified by the American Board of Otolaryngology

 

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DISCLAIMER:  The purpose of this website is to provide general information and not medical advice.  This website is not a substitute for consultation with a physician.  Information contained herein is believed to be accurate, but no warranty is made as to accuracy or appropriateness.  Information contained herein may be outdated or incomplete.