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Patient Information - Epistaxis (Nose bleeds)

Epistaxis (Nose bleeds)

Patient information leaflet

 

Emergency Department

 

Darent Valley Hospital

Darenth Wood Road

Dartford

Kent

DA2 8DA

 

01322 428100

www.dgt.nhs.uk  

 

Author: Dr Stephanie Soyombo

Title: Emergency Department Doctor

 

Information accurate at time of going to print.

            

            

What is a nosebleed?

 

Epistaxis is the medical word for bleeding from the nose. The common site for a nosebleed is to start in the ‘Little’s area’. This is just inside the entrance of the nostril, on the nasal septum (the middle part of the nostril). The blood vessels here are quite fragile and can easily rupture, for no apparent reason.

Causes of nosebleeds

• If you pick your nose
• If you have a cold or blocked stuffy nose from something like hayfever
• When you blow your nose
• Changes in temperature
• Minor injuries to the nose

 

In most cases, the bleeding may only last a short time and is usually easy to control. The bleeding may be more prolonged and harder to stop if you have: high blood pressure, heart failure, a blood clotting disorder, or are taking 'blood thinning' drugs (anticoagulants) such as Warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban or Clopidogrel, Ticagrelor.

Treatment for a nosebleed

Sitting forward with your mouth open and spit out any blood – try not to swallow blood as it will irritate your stomach and make you feel sick.

 

1. Pinch hard the fleshy/flexible part of your nose. It is useless to put pressure over the root of your nose or nose bones.
2. Apply an ice pack over the bony bridge part of your nose (a pack of frozen peas may be used) and suck an ice cube. The cold helps the blood vessels to constrict (become narrow) and stop bleeding.
3. Try to remain calm and rest quietly.
4. If after 20 minutes it has not stopped, seek medical advice.

Treatment in hospital

Nasal cautery

If the bleeding continues, your doctor may use a cautery stick, essentially a cotton bud with silver nitrate on the tip. If the doctor can identify the bleeding point, they will use the cautery stick to seal the area of bleeding and you will be able to go home. Use of the stick may sting for a moment. If nasal cautery is not successful, we may need to admit you for further treatment.

 

 

 

 

Nasal packing

Your nose may require packing, with a sponge or a ribbon dressing (a soft absorbent device into a nostril), to stop the bleeding. If it is severe you may need packing with an epistaxis balloon. The packing will completely block your nose and you will need to breathe through your mouth.

 

If your nose is packed, this will remain in place for 24 to 48 hours. Since your nostril will be blocked you may experience: a mild headache, dry mouth, reduced appetite, reduced taste sensation, difficulty swallowing, or watery eyes. We may be able to discharge you home with an ENT clinic appointment but it may be necessary to admit you for further treatment.

Discharge advice 

You should take the following precautions for at least two to three days after a nosebleed, or until after all the bloodstained discharge has stopped. 

 

• Avoid very hot or cold drinks. 
• Avoid hot baths or showers. 
• Do not blow your nose - sniff gently instead. 
• Do not pick your nose. A small scab will form and it should not be disturbed. 
• If you need to sneeze, do so with your mouth open. 
• Avoid any strenuous activity. 
• Avoid smoking, smoky atmospheres and drinking alcohol. 

 

Further Support 

For general medical advice please use the NHS website, the NHS 111 service, walk-incentres, or your GP. 

 

NHS website provides online health information and guidance at www.nhs.uk

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This leaflet has been developed in partnership with the Patient Information Group and our DGT Patient Partners

 

 

 

Patient Information

Further patient leaflets are available from the Dartford and Gravesham NHS Trust website: https://www.dgt.nhs.uk/patients-and-visitors/patient-information-leaflets Please ask a member of staff if you require information in another language or format.

 

Complaints, Comments, Concerns and Compliments

Please speak to the staff in the ward or department caring for you if you have any concerns or questions relating to your care or that of a loved one.

Compliments can be shared by visiting: https://www.dgt.nhs.uk/contact-us/compliments

Alternatively, please contact the Patient Advice and Liaison Service (PALS) on 01322 428382 Email: dgn-tr.PALS@nhs.net 

 

Patient Property

Please do not bring large sums of money or valuable items into the hospital. Dartford and Gravesham NHS Trust accepts no responsibility for the loss or damage to personal property unless it is handed into Trust staff for safe-keeping.

 

 

Dartford and Gravesham NHS Trust operate smoke-free hospitals. This means that smoking is not permitted anywhere on hospital grounds. For help to quit smoking please visit www.kentcht.nhs.uk/service/one-you-smokefree/  

Use of alcohol or illicit drugs is not permitted anywhere on the hospital site. For drug and alcohol support please speak to your nurse or doctor or 

Visit: www.changegrowlive.org/westkent/help  

Call: 0330 128 1113

 

 

 

Reference Number: 05

 

First published:                              Last Reviewed:                                                     Next review date:

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