Nose Bleeding
Bleeding from the nostrils, which may be arterial or venous
Causes
- Local: nose-picking, trauma, nose infections, tumours
- General: hypertension, bleeding disorders, pertussis, Sickle-cell trait/disease, renal failure, often familial
- Can also be a symptom of serious disease, e.g., typhoid, malaria, viral fevers such as Ebola
Clinical features
- On examination, site of bleeding from nose may be seen
- Signs and symptoms of shock if bleeding is severe
- Signs and symptoms of predisposing cause
Differential diagnosis
- Clinical assessment to exclude any of above causes
Investigations
- Blood: Full blood count, platelet count
MANAGEMENT
First aid
- Sit the patient up (if patient not in shock) and tilt head forward not backwards to avoid pooling of
blood in posterior pharynx - Instruct patient to pinch the nose between the finger and the thumb for 15 minutes, breathe
through the mouth, and spit out any blood
If bleeding continues
- Impregnate a gauze strip with Soft paraffin or Tetracycline eye ointment and pack into the nose
using forceps - Leave gauze in place for 24-48 hours
If bleeding still does not stop after this period
- Refer to hospital for further management
Prevention
- Avoid picking the nose
- Treat/control predisposing conditions