Nosebleeds: dos and don’ts
If you ever watched the TV show Frasier, you may remember that of the main characters, Frasier’s brother, was said to have a nosebleed every time he tells a lie. You see him reaching for his nose when he makes up excuses. It is like a modern version of Pinocchio. Let’s discuss some common sense advice, and first, review a few basics. Here we will only talk about the common and non threatening nosebleed.
Definition: the medical term for a nosebleed is epistaxis. It is generally not a severe condition but it can cause a problem when it happens often, especially in older people and in young kids (it can also frighten them). It is caused by the rupture of the capillaries of the nasal mucous membrane when those small vessels become dilated, which is the case in hay fever. The nasal mucous membrane is highly vascularized and that is what makes it more prone to bleeding.
Most frequent causes
- dry air
- change in altitude (airplanes, hiking, etc.)
- trauma (scratching or external trauma)
- crusty rhinitis (that can be associated with scratching to remove the crust)
- certain medicines that have an anti-coagulation effect (aspirin, blood thinners), and certain blood diseases
- some health conditions such as hypertension, diabetes, etc.
- Like in the TV show, there could also be a psychological component that triggers the episodes in someone who has more fragile capillaries.
What are the signs
They are very obvious and the blood generally comes from the front part of the nose (anterior nosebleed) and it stops after a few minutes. In some rare cases, the bleeding comes from the bigger blood vessels that are in the back part of the nose (posterior nosebleed) and those can be dangerous. They usually happen after an injury and in older people regularly taking aspirin or blood thinners or suffering from hypertension or renal insufficiency.
What to do and what not to do
- Blow your nose very gently to evacuate clots.
- Avoid physical efforts and sit down. While seated rest your elbow on a table and apply pressure on the nostrils with your thumb and index finger for approximately 5 to 10 minutes.
- Put an ice cube at the root of the nose.
- Calmly breath through your mouth.
- Spit out any blood that drips into your mouth instead of swallowing it as it would make you nauseous.
- Apply a nosebleed dressing inside the nostrils if necessary at this point. You can use a specific dressing or if you do not have any, use a piece of gauze.
- Rest for at least one hour.
- In all case, do not panic!
- Last, be aware that some people do not handle the sight of blood well and might faint and hurt themselves. That is why you should always make someone with a nosebleed sit.
- One of the things that the Frasier character does is tilt his head upward and walk around for comical purpose. In real life, this is not a good idea as you could swallow or, even worse, inhale blood. On the contrary, sit down and tilt your head downward. If you cannot contain the bleeding with a tissue right away, bend your head over a bowl and spit out the blood. Then compress your nose to stop the bleeding that should happen within a few minutes.
- Once you have evacuated the clot(s) do not blow for at least 4 hours.
- Of course, if all those measures do not make the bleeding stop within 10 minutes, or if the bleeding is abundant or accompanied by other symptoms, call your physician or go to the ER. In any case it would be a good idea to consult a physician afterward to seek what caused the episode.
Especially for people who are more prone to nosebleeds, such as children and the elderly:
- Try to maintain a cool temperature in your bedroom. This makes the air less dry. You can also use an air humidifier or just put a bowl of water next to your bed at night (you can add two or three drops of good quality essential oils such as eucalyptus or lavender, or even a blend by Nature’s Truth)
- Hydrate the mucous membrane in your nostril by applying a thin layer of Calendula Ointment by Hyland or Boiron. You also can do nasal irrigation with saline solution but be cautious and do it very gently
- Stay away from alcohol and hot beverages when possible
- Drink enough water through out the day
- Smoking should also be avoided