Epistaxis (epistaxis)

21 October 2017

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No panic: nosebleeds usually looks worse than it really is! Usually the cause is harmless and after a few minutes it stops by itself again. Still, many wonder: What to do when suddenly blood dripping from the nose or shoot?

Generally at nosebleed: Stay calm and bend your head forward, so that the blood can flow out of the nose. Take, if possible, an upright position - that is, sites or sit down and let out the blood flowing from his nose. At the same time you should squeeze affected nostril for some time, until the bleeding stops or can wait for further action.

Hear the nosebleed after 15 minutes not, you should definitely see a doctor or go to the hospital. The doctor can the bleeding using special nasal packing to stop. 

In most cases, no further treatment is necessary. However, those who constantly has nosebleeds for no apparent reason, which may be useful that the doctor often obliterates the bleeding vessel in the nose, for example by laser.

Why should you put your head not to the back of the neck

In nosebleeds you should tilt your head always forward - not backward! If you tilt your head back, the blood flows into the throat and can be as in the lungs or into the stomach. This can cause the person concerned to cough or nausea and vomiting (vomiting blood). Arrives at the nosebleed blood in the mouth, it is therefore also advisable to spit out the blood and not swallow.

Nosebleeds (epistaxis fachsprachlich) arises when one of the fine to break or tear blood vessels of the nasal mucosa. There is usually for a harmless explanation. Especially in children and adolescents nosebleed occurs often for no apparent reason on.

The most common causes of nosebleeds are

Especially in winter nosebleeds may occur more frequently because the warm air heating dries out the nasal mucous membranes. The dry nasal mucosa is no longer as resistant and can break down more quickly - for example, when blowing your nose or by vigorous sneezing.

Tip: Who often gets nosebleeds for no reason in the winter due to dry nasal mucosa, which should an Nasal spray with sea water or isotonic saline fall back on. These preparations moisturize the nasal mucosa and generally have no side effects.

In addition to dry air, there are other factors that may favor the development of nosebleeds - for example, a pregnancy or stress.

In addition, there are some blood-thinning and anticoagulant drugs (Such as aspirin, warfarin, heparin, hirudin, dabigatran or rivaroxaban) that may cause epistaxis. Often the bleeding in these patients can stop not as good as the bleeding continues longer due to the blood-thinning medication.

In rare cases can also different diseases behind the nosebleeds, for example,

Occasional nosebleed is usually harmless. For frequent and heavy nosebleeds, it is important to have a specific diagnosis by the ENT doctor ask to leave. Epistaxis (also called epistaxis) can be seen at the outlet of a light red or dark red, sometimes clumped (coagulated) blood from one or both nostrils.

To find out what has caused exactly epistaxis, ear, nose and throat specialist performs a so-called nose (rhinoscopy). Mostly, the reflection of the front nose portions sufficient to the to determine the source of bleeding. Here, the ENT specialist considers the nasal cavity and the anterior nasal passages by means of nasal speculum - a pincer-like device with a funnel-shaped tip, as well as a light source or a reflective mirror.

If necessary, more further investigations necessary to avoid injury. In a serious blow to the nose, for example, the physician orders an X-ray image of the head. On the radiograph, it can detect whether injury in the nose and head area are available.

Other imaging methods, which the physician can draw with frequent and severe nosebleed, the computed tomography (CT) and magnetic resonance imaging (MRI), as well as the angiography for displaying the blood vessels. These methods are used for nosebleeds but very rarely.

In order to detect systemic diseases such as hypertension or anemia as the cause of frequent epistaxis, further investigation by a general practitioner or specialist in internal medicine (Internist) are required.

the bleeding will not stop simple, that is when it more than 15 minutes continues, you should definitely consult an ear, nose and throat doctor or go to the hospital. The doctor can stop the bleeding by special as nasal packing introducing into the nose. Also decongestant nasal sprays can sometimes help to stop the bleeding. 

Did the doctor made the bleeding vessel locate in the nose, he can also use this etch of 40 percent trichloroacetic, so that the bleeding stops.

Nosebleed comes in children - especially in young children - often before. The cause is then usually too deep nose picking or a blow to the nose while playing or racks. Especially in young children, it can also happen that they are foreign objects, such as a marble, stuck in the nose and thus hurt the delicate nasal mucosa. Rarely puts a disease behind it. 

If the child is bleeding from the nose at once, it is first important that it's bends head forward, so that no blood enters the stomach or respiratory tract. Then the parents or guardian can try to stop the bleeding by cooling of the neck. To this end, a cold, damp washcloth that you put the child on the neck is. 

At the same time the child should compress the nose with a handkerchief to stanch the nosebleed. In particularly severe nosebleeds for this purpose a nasal packing is suitable.

Do you feel that your child has particularly frequent nosebleeds? Then make an appointment with the pediatrician. It can determine why your nose is bleeding more frequently with your child than other children. Did he recognize the causes, the pediatrician itself or an ear, nose and throat doctor can usually immediately begin the appropriate therapy - for example, by the nose an expanded blood vessel desolated (Embolization).


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