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Nosebleeds
Nosebleeds - Care And Prevention
Most nosebleeds are mere nuisances- but some are quite frightening, and a few are even
life threatening. Physicians classify nosebleeds into two different types.
Anterior Nosebleed:
The nosebleed that comes from the front part of the nose and begins with a flow of blood
out one or the other nostril if the patient is sitting up or standing.
Posterior Nosebleed:
The nosebleed that comes from deep in the nose and flows down the back of the mouth
and throat even if the patient is sitting up or standing.
Obviously, if the patient is lying down, even the anterior nosebleeds seem to flow in both
directions, especially if the patient is coughing or blowing his nose.
Nevertheless, it is
important to try to make the distinction since posterior nosebleeds are often more severe
and almost always require the physicians care. 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.
Nosebleeds in children are almost always of the anterior type. Anterior nosebleeds are
common in dry climates or during the winter months when the dry air parches the nasal
membranes so that they crust, crack, and bleed. This can be prevented by placing a bit of
antibiotic ointment about the size of a pea on the end of your fingertip, then rubbing it
up inside the nose, especially on the middle portion (the septum).
Many physicians suggest any of the following lubricating creams or ointments, which can be
purchased without a prescription: A and D ointment, Bacitracin or Neosporin ointments.
These may be applied up to three applications a day, but usually every night at bed-time
is enough. If the nosebleeds persist, you should see your doctor, who may recommend
cautery to the blood vessel that is causing the trouble.
To Stop An Anterior Nosebleed
If you or your child has an anterior nosebleed, you may be able to care for it yourself
using the following steps:
1. Pinch all the parts of the nose together between your thumb and
two fingers.
2. Press firmly toward the face-compressing the pinched
parts of the
nose against the bones of the face,
3. Hold for 5 minutes (timed by clock).
4. Keep head higher than the level of the heart. Sit or lie
with head elevated.
5. Apply ice (crushed in a plastic bag or washcloth) to nose
and
cheeks.
6. Gargle with ice-water until the returns are clear
(no more than 5 minutes)
To Prevent Re-bleeding After Bleeding Has Stopped
1. Do not pick or blow nose.
2. Do not strain or bend down to lift anything heavy.
3. Keep head higher than the level of the heart.
4. Do not eat or drink anything warmer than room temperature for
12 hours.
If Re-bleeding Occurs
1. Clear nose
of all blood clots by blowing it forcefully.
2. Spray nose four times on both sides with decongestant
spray (such
as Afrin, Duration, Neo-Synephrine
etc.).
3 . Pinch and press nose into face as in steps 1-6)
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04/23/01
Copyright © 1999
Berkshire Ear, Nose, Throat, &
Audiological Associates, P.C. All rights reserved.
510 North Street
Pittsfield, MA 01201
413 448 8291
Fax 413 447 9040

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