Nose bleeding

Nosebleeds are mostly short-lived, stop easily and do not apply to a health institution. The rate of encountering a nosebleed in a lifetime is 60%, and only 10% require medical attention. It is more common in winter. Nose picking and decreased humidity of the mucous membrane covering the inside of the nose are the most common causes of nosebleeds in children during the winter months. Curvatures in the middle part of the nose; Especially the curvatures and protrusions in the front can cause increased turbulence in the nose, dryness and nosebleeds. Traumas that cause fractures in the nasal bones can also cause damage and bleeding in the mucous membrane that covers the inside of the nose. Delayed (after 6 weeks) bleeding after traumas that cause fractures of the facial bones may be caused by posttraumatic aneurysm (ballooning of the vessels). Nose bleeding is not uncommon after nasal surgeries (septoplasty, rhinoplasty, endoscopic sinus surgery, etc.). Benign and malignant tumors of the nasal cavity, sinuses and nasopharynx (nasopharynx) should be investigated, especially in recurrent and persistent nosebleeds.

Publications report that people over the age of 50 are more prone to severe nosebleeds. Congenital or acquired bleeding-coagulation disorders (easy bruising, prolonged bleeding in minor injuries, family history of bleeding disease) should also be carefully evaluated in patients with epistaxis. The patient’s history gives important clues in acquired bleeding disorders caused by drugs or disease. If the platelet count (the blood element that ensures blood clotting) is below 20 000 /mm3, it causes spontaneous bleeding. Some drugs can cause bleeding by disrupting platelet functions. Chronic alcohol consumption, aspirin, and some medications can cause nosebleeds. Vitamin K deficiency; and liver diseases that cause it, diet and some drugs can cause nosebleeds due to decreased clotting factors.

General precautions and recommendations for moderate and light bleeding without active bleeding are as follows:

Reducing the factors that will increase the initiation of nosebleeds. First of all, it can be listed to reduce the habit of not picking the nose and cleaning the nose frequently, to increase the humidity of the nose with salt water solutions, nasal gels. It is recommended to moisten the environment we are in with various tools. In acute bleeding, the first and early intervention can be summarized as washing the nose with cold water to clean the clots, tilting the head forward 45 degrees, squeezing the anterior soft wings of the nose with the index and thumb and waiting for 10 minutes. It would be appropriate to apply to the emergency room for bleeding that does not stop at the end of this intervention.
Anterior packing application, anterior nasal cauterization, posterior packing application, various surgeries in which the bleeding artery is connected by surgical methods and septoplasty can be listed as applications that can be performed by an ENT specialist in operating room conditions in active and unstoppable bleeding with the above precautions.

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