Epistaxsis ( Nose Bleeds )

Causes of Nose Bleeds

Nose bleeds are all too common. Approximately 60 to 65 percent of the population will experience a nose bleed in their lifetime. Cause vary from direct trauma, to dry air, picking your nose, altitude changes, people on blood thinners, uncontrolled high blood pressure, pregnancy and those that have clotting disorders. In the outdoors dry air and high altitude are large contributors.

Types of Nose Bleeds

There are two types of nose bleeds anterior, the least severe and most common and posterior nose bleeds, the most concerning.

Anterior nose bleeds

These are the bleeds that occur toward the front of your nose near the inner soft, friable tissue. These vessels are small in comparison to the posterior vessels. Anterior nose bleeds can be stopped with direct pressure most of the time.

Posterior nose bleeds

These are bleeds that originate in the back of the nose. They are difficult to stop and should be referred to an ENT specialist or Emergency Department. You know if you have a posterior bleed if the bleeding cannot be stopped after twenty minutes or there about and the bleeding is consistently draining down the back of your throat.

Treatment of Nose Bleeds

1. Try and hold pressure on your nose by pinching your nose below the bony prominence and just above your nasal flares. Tilt your head forward so the blood does not drain down the back of your throat, breath through your mouth and hold this pinching technique for ten to fifteen minutes. Time this maneuver. The vast majority of people do NOT hold they technique long enough and then they have a poor outcome.
2. If that does not work then one can use the packing mechanism. ( see video for demonstration .) The packing method is used with glaze strips or cotton strips that are cut very thin. Soak the gauze or cotton in Benadryl ( diphenhydramine ) along with a nasal spray such as Afrin. Any nasal spray will work as long as it has Oxymetazoline in it. Pack your nose till it feels uncomfortable. You now have direct pressure working for you as well as Oxymetazoline which is a vasoconstrictor. I advise some gasoline place first in your nose, especially if the packing will remain in for a long time. The Vaseline will aid in keeping the area moist and you will have less of a chance of disrupting a scab and starting another nose bleed. This packing can remain in for hours and I have left some in as long as 24 hours which is directly dependent on the severity of the bleed, if the person has a history of recurrent bleeds or if they are on a blood thinner such as an Aspirin a day or other type meds.

Follow Up

I always advise following up with your PCP Primary Care Provider when you return from your camping trip or hiking expedition.