Nose bleed, causes and treatments

         Nosebleeds, also called epistaxes involve bleeding from the inside of your nose. Many people have occasional nosebleeds, particularly younger children and older adults.
Although nosebleeds may be scary, they're generally only a minor annoyance and aren't dangerous. Frequent nosebleeds are those that occur more than once a week.                                                                                                                                                                            
 Causes                                                                                                                                                                                                                                                                                                 Taking antihistamines and decongestants for allergies, colds, or sinus problems can also dry out the nasal membranes and cause nosebleeds. Frequent nose blowing is another cause of nosebleeds. Other common causes of nosebleeds include: foreign object stuck in the nose.                                                                                                                                                                                                                                                                           What to do when you have a nosebleed

Most nosebleeds can be stopped without the need for medical attention, but occasionally further treatment may be required.

To stop a nose bleed:

• sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10-15 minutes
• lean forward and breathe through your mouth – this will drain blood down your nose instead of down the back of your throat
• place an ice pack or bag of frozen vegetables covered by a towel on the bridge of your nose 
• stay upright, rather than lying down as this reduces the blood pressure in the blood vessels of your nose and will discourage further bleeding

If the bleeding eventually stops, you won't usually need to seek medical advice.                                                                                                                                                                                            
    Seek medical advice for a bleeding nose if:

• you're taking a blood-thinning medicine (anticoagulant) such as warfarin or have a clotting disorder such as haemophilia and the bleeding doesn't stop
• you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion
• a child under two years of age has a nosebleed (this is rare and there's a chance it's caused by something serious)
• you have nosebleeds that come and go regularly                                                                                                                                                                                                        Medical treatment for a bleeding nose:
  The two main treatments that your hospital doctor may use to stop your nose bleeding are cautery and nasal packing. These are described below:                                                                       Cautery
  If your doctor is able to identify exactly where the bleeding is coming from, they may carry out a minor procedure to seal the bleeding blood vessel by cauterising (burning) it.
  This is normally done using a stick of a chemical called silver nitrate. A local anaesthetic will be sprayed into your nose to numb it and the silver nitrate stick will be held against the bleeding point for up to 10                                                                                          Nasal  packing 
          
  Additional treatments that may be used in hospital include:
  • electrocautery – an electric current running through a wire is used to cauterise the blood vessel where the bleeding is coming from
  • blood transfusion- a procedure to replace the blood you've lost
  • tranexamic acid – medication that can reduce bleeding by helping your blood to clot
  • packing under anaesthetic – your nose is carefully packed with gauze while you are unconscious from general anaesthetic
  • ligation – an operation using small instruments to tie off bleeding blood vessels in the back of your nose
  Go to hospital with a nosebleed, you will be assessed to determine how serious   your condition is and what's likely to have caused it. This may involve looking inside your nose, measuring your pulse and blood pressure, carrying out blood tests and asking about any other symptoms you have   If cautery is ineffective or your doctor is unable to identify a specific bleeding point, they may recommend packing your nose with gauze or special nasal sponges to stop the flow of blood by applying pressure to the source of the bleeding.  Packing will usually be carried out after local anaesthetic has been sprayed into your nose. The gauze or sponges often need to be left in place for 24-48 hours before being removed by a health professional. You'll usually need to be admitted to hospital to be monitored during this                                             If the treatments above don't help, you may be referred to a hospital specialist such as an ear, nose and throat (ENT) doctor for further treatment.
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