Nosebleeds (Epistaxis) Causes, First Aid Treatment

The sight of blood from any place other than a minor cut on the skin scares more of us. When it comes from a cavity like the nose it is even more worrying. But minor nosebleeds are not uncommon and in most cases it is not serious. Understanding why nosebleeds occur is important to prevent it, especially if your are a frequent bleeder. Most of the time it can be easily remedied at home, although frequent nosebleeds that are due to underlying conditions may require medical attention.

What is a nosebleed?

A nosebleed is bleeding from the nasal cavity. The medical term for a nosebleed is epistaxis. It may lead to bleed dripping out of the nose but sometimes a minor bleed can occur within the nose and never leak out, especially when you are lying down. Instead you may find dry and congealed blood mixed with the hardened mucus (‘boogers’) when picking or blowing the nose. Irrespective of how it exits the nose, the point is that blood loss has occurred within the nasal cavity of from neighboring areas like the paranasal sinuses.

Causes of Nosebleeds

The lining within the nasal cavity is rich in tiny blood vessels. A break in one of the small vessels can cause significant blood loss so the severity of the bleed is not necessarily an indication of the seriousness of the underlying cause. However, the longer a nosebleed lasts the more likely the cause is severe. The most common cause of nosebleeds  is nose picking. The fingernail in particular damages the inner lining of the nasal cavity, especially with vigorous picking. The other common cause is dry air. The lining dries up and is easily injured during picking or becomes infected.

Other causes include:

  • Blow to the nose with a fall, sporting injury or assault.
  • Allergies affecting the nose and paranasal sinuses in particular.
  • Infections of the nose and paranasal sinuses.
  • Nasal inflammation (rhinitis) which is not due to an infection.
  • Medication like aspirin and warfarin which affects blood clotting.
  • Foreign body (object) in the nose which is more common among children.
  • Chemical irritants that may enter the nose.
  • Substances like cocaine which may be sniffed and cause abrasions.
  • Overuse of nasal sprays.
  • Deviated septum.

There are also uncommon causes like nasal bleeding with alcohol use, surgery to the nose and even tumors. Contrary to popular belief, hypertension (high blood pressure) is not a common cause of nosebleeds.

First Aid Treatment

First and foremost it is important not to panic at the first sign of a nosebleed. As mentioned the odd nosebleed is rarely ever serious. The simple measures discussed below are effective but a nosebleed that lasts for more than 30 minutes or when accompanied by symptoms like blurring vision, dizziness, difficult breathing or loss of consciousness requires immediate medical attention. Remember that a nosebleed is a sign of some underlying cause. Sometimes these causes can be deadly.

  • Immediately place pressure on the nose by pinching it between the thumb and index finger. The pressure should be maintained for 5 to 10 minutes before releasing to verify whether the nosebleed has stopped.
  • Sit up and lean forward. Lying flat can increase the blood pressure to the nose and increase bleeding. Tilting your head back or lying flat can allow blood to drain to your stomach which is not desirable.
  • Avoid picking your nose or placing any object in it. Even if the nosebleed stops the area may still be prone to bleeding. Sticking your finger in your nose may dislodge a clot or start a new bleed.
  • Do not take aspirin or other medication that may ‘thin’ the blood unless it is has been prescribed by a doctor. Rather use acetaminophen to relieve pain that may have arisen with a blow to the nose that led to the bleeding.

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