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Showing posts with label cautery. Show all posts
Showing posts with label cautery. Show all posts

Thursday, September 13, 2007

A Simple Guide to Nosebleed (Epistaxis)


A Simple Guide to Nosebleed (Epistaxis)
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What is a Nosebleed?
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A Nosebleed is said to have occurred when the nose begins to bleed from the inner mucosa or lining of the nose. It does not refer to bleeding from the external skin of the nose.

What causes a Nosebleed?
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Spontaneous:
There is a layer of moist, delicate skin with a rich supply of blood vessels involving the lower front portion of the nasal septum of the nose called the Little's area. These blood vessels tend to bleed rather heavily and can be easily damaged as they are rather superficial.
Most nosebleed are anterior and may be caused by
1.irritation or dryness of the lining of the nose, which may occur with low humidity and dry environment,
2. allergic rhinitis, colds, or sinusitis.
3.Deviated septum,
4.foreign objects in the nose, or other nasal obstruction may also cause nosebleeds.

There are rare occasions whereby a nosebleed is life threatening or fatal.
In these rare cases, the bleeding is usually from a posterior nosebleed, where the site of bleeding is higher and deeper within the nose and the blood flows primarily down the back of the throat.

Underlying health conditions such as:
1.Fever,infections
2.hypertension,
3.bleeding disorder including blood cancer,
4.the use of anticoagulant medication that is often working against the clotting process.

What are the risk factors of a Nosebleed?
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The common risk factors include:
1.A hot, dry indoor climate - hot, dry air causes the delicate nasal skin to crack and bleed.
2.,Colds and allergies - Upper respiratory tract infections and allergies both trigger nasal inflammation, which can increase the risk of bleeding.
3.Exposure to irritating chemicals - Cigarette smoke, passive secondhand cigarette smoke, on-the-job exposure to sulfuric acid, ammonia, gasoline or other chemical irritants.
4.A deviated septum - A nasal septum that is deviated (shifted away from the midline) produces an uneven airflow pattern within the nostrils. The altered airflow pattern causes the skin on the nasal septum to become dry and cracked, increasing the risk of bleeding.
5. trauma, such as nose picking, forceful blowing of the nose or severe facial trauma from an automobile accident or contact sports.
6.Heavy alcohol use - Alcohol seems to interfere with the normal activity of platelets in the blood, and this increases the time needed for blood clots to form.
7.Medications that delays blood clotting - anticoagulants and nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen.
8.Medical conditions - Examples include chronic renal disease (kidney failure), thrombocytopenia (low platelets) ,leukemia,hemophilia, hereditary bleeding disorders,

What are the Symptoms of a Nosebleed?
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Symptoms include:
bleeding from one or both nostrils
frequent swallowing
sensation of fluid in the back of the nose and throat

What is the Treatment of a Nosebleed?
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Pressure & posture:
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If there is bleeding from the front of your nose, begin by trying the following first-aid measures:
Sit up, lean forward and breathe through your mouth.
Pinch the entire front of your nose, just above your nostrils, and hold it for five minutes. Apply an ice pack or a plastic bag of crushed ice to your nose to slow the blood flow.

After you have pinched your nose for five minutes, release it to see if the nosebleed continues. If your nose is still bleeding, pinch it for an additional 10 minutes. After 10 minutes, release your nose again. If you are still bleeding, seek emergency medical help. After the blood flow has stopped, try not to breathe through your nose.

If simple first aid fails, your doctor may treat the problem by:
Packing your nose with gauze
Cauterizing (sealing off) the injured blood vessel with an electric probe
Applying medication such as silver nitrate directly to the inside of your nose to stop the bleeding
Using cryotherapy (using cold temperature to freeze the site of bleeding), laser therapy (using a laser beam to seal the bleeding blood vessel)
Postnasal plugging
Surgery

What are the Prevention measures for Nosebleed?
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Here are some things you could do to prevent nosebleeding:
Not picking your nose
Being gentle when you blow your nose
Not smoking
Using a nonprescription saline nasal spray to moisturise the inside of your nose
Applying a tiny dab of petroleum jelly to the inside of your nostrils before bedtime
Avoiding facial trauma - by wearing a seatbelt in the car and by using well-fitting headgear to protect your face during contact sports
Using protective equipment to avoid breathing chemicals at work
Colds, other viruses, and allergies may also irritate the lining of the nose.

So the next time your child gets a nosebleed, try not to panic. They're usually harmless and are almost always easy to stop.

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