2-27
Section VI. DISORDERS INVOLVING THE UPPER RESPIRATORY SYSTEM
2-27. EPISTAXIS
Nosebleed, called epistaxis, is caused by the rupture of the tiny blood vessels in the nose. Most often, the vessels ruptured are those in the mucous membranes of the nose.
a. Epistaxis may be caused by injury, such as a blow to the nose, "picking" the nose, or forceful blowing of the nose. Nosebleed may also occur as the result of disease or may occur as a symptom of conditions such as sinusitis, bleeding disorders, or hypertension.
b. Epistaxis can often be managed conservatively by compressing the nostril of the affected side against the nasal septum for 5-10 minutes. A cold compress over the nose is also effective in the reduction of both bleeding and swelling. Position the patient with the head forward to allow blood to drain from the nose and
not down the throat. Swallowing the blood may lead to nausea and vomiting. Instruct the patient to breathe through the mouth. If the source of the bleeding cannot be seen, the physician may spray the interior of the nose with an epinephrine solution, which will constrict the blood vessels, and pack the interior of the nose with gauze, which will act as a pressure dressing.
