What to do if your nose bleeds

Because trauma and impact can cause nose bleeding, nose bleeding is an emergency. In case of severe bleeding, the patient needs to tilt his head back and use some objects to block the nasal cavity to prevent the blood from flowing out of the nose again. Do a good job of local cleaning and give appropriate hemostatic drugs. Cold compresses can be used to coagulate the blood to prevent recurrence of bleeding.

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Nosebleeds are generally considered emergencies. In cases of severe bleeding, the patient and his or her companions are often nervous. If necessary, chlorpromazine or luminal sodium can be injected to calm the patient and reduce bleeding. Applying cold compresses to the neck, nape, head and chest can also reflexively reduce bleeding. If the patient is in shock, first provide first aid according to the shock condition.

1. Local treatment

Generally, the patient is in a sitting or semi-sitting position (the patient in shock is placed flat on his back) to first remove all the packing and blood clots in the nasal cavity, and use ephedrine cotton pads to shrink the nasal mucosa. Remove them after 10 minutes, and examine the nasal cavity and nasopharynx in detail. According to the bleeding situation and bleeding site, choose appropriate methods to stop the bleeding. Do not wipe indiscriminately without principles. When stopping bleeding, be gentle to avoid causing new trauma and further bleeding.

1. Local hemostatic drugs: They should be used first for lighter anterior nasal bleeding because they cause less pain to the patient and sometimes have special effects.

2. Cauterization: It is suitable for patients with repeated small-amount bleeding and fixed bleeding points, but it is ineffective for arterial bleeding. There are two methods: chemical cautery and electrocautery.

3. Cryohemostasis.

4. Nasal packing: used when bleeding is severe or the bleeding site is unknown.

5. Posterior nasal packing: If bleeding continues after nasal packing and flows backwards into the pharynx or out of the opposite nostril, it means that the bleeding point is in the back of the nasal cavity and it is advisable to use a conical gauze ball to pack the posterior nasal cavity.

6. Nasopharyngeal packing: It is used for severe bleeding near the posterior nasal aperture or nasopharynx, or the bleeding is very deep and the bleeding site cannot be identified for the time being. If the posterior nasal aperture packing is ineffective, nasopharyngeal packing can be used.

7. Endoscopic electrocoagulation hemostasis: suitable for those with hidden bleeding sites deep in the nasal cavity.

8. Surgical treatment:

(1) Septum surgery: For patients with recurrent nosebleeds caused by a deviated septum, ridge or calcarine process, submucosal septum resection can be performed. If there is no obvious deviation of the nasal septum but bleeding occurs repeatedly on the septum mucosa and other methods cannot cure it, nasal septum mucosal scratching or nasal septum submucosal separation can be performed.

(2) For nosebleeds caused by nasal or paranasal sinus tumors, depending on the specific situation, either stop the bleeding first or perform surgery to remove the tumor. Either radiotherapy or ligation of the blood vessels in the neck can be used to stop it.