Materiały źródłowe

• #1 Nosebleeds (Epistaxis): Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis

  Epistaxis, or a nosebleed, is when you lose blood from the tissue that lines the inside of your nose. There are simple steps you can take to treat and prevent them. Although annoying, nosebleeds usually aren’t a cause for concern. […] Nosebleed treatment depends on the cause of the bleeding. Your provider will explain what’s necessary in your situation. Epistaxis treatment may include: Nasal packing. Your healthcare provider inserts gauze, special nasal sponges or foam, or an inflatable latex balloon into your nose to create pressure at the site of the bleed. Your provider may want to leave the material in place for 24 to 48 hours before removing it. […] What are the treatments for epistaxis? Cauterization. This procedure involves applying a chemical substance (silver nitrate) or heat energy (electrocautery) to seal the bleeding blood vessel. Your provider sprays a local anesthetic in your nostril first to numb the inside of your nose.

• #1 Nosebleeds: First aid

  https://www.mayoclinic.org/first-aid/first-aid-nosebleeds/basics/art-20056683

  Nosebleeds, also called epistaxis (ep-ih-STAK-sis), are common. They happen when the tender blood vessels in the nose break. Common nosebleed causes can include changes of season, dryness, scratching, some medicines and injuries. People on blood thinners may have worse nosebleeds than do others. Most often nosebleeds are only annoying and not a true medical problem. But they can be both. […] Follow these steps to treat a common nosebleed. […] Pinching puts pressure on the blood vessels and helps stop the blood flow. […] If the bleeding doesn’t stop, pinch the nose again for up to 15 minutes. […] Seek emergency care if the bleeding doesn’t stop after the second try. […] You may need to have a blood vessel cauterized. Cautery is a method that burns and seals blood vessels using electric current, silver nitrate or a laser. […] A care provider might pack the nose with special gauze or an inflatable latex balloon. Both packing methods put pressure on the blood vessel and stop the bleeding. […] Think about using a humidifier. Adding more moisture in your home may help relieve nasal bleeding.

• #1 How To Stop & Prevent Nosebleeds

  https://www.webmd.com/first-aid/nosebleeds-causes-and-treatments

  Nosebleeds usually arent serious. You can treat most by yourself at home by doing the following: Stay calm. If you start to get nervous, it can actually make you bleed more. Try to relax. Sit up, dont lie down. Keep your head above your heart. Lean a little bit forward. This keeps the blood from draining down the back of your throat. Pinch your nostrils closed. Use your thumb and index finger to hold your nostrils closed for 5 to 10 minutes while you breathe through your mouth. This puts pressure on the part of your nose thats bleeding and can make the blood stop flowing. […] Once the bleeding has stopped, do not touch or blow your nose. This may start it bleeding again. But if it does restart, gently blow your nose to get rid of any blood clots. You can also spray a decongestant such as oxymetazoline (Afrin, Mucinex, or Vicks Sinex) in both nostrils. Then pinch your nostrils shut and breathe through your mouth for 5 to 10 minutes.

• #1 Nosebleed Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/nosebleed

  A nosebleed is loss of blood from the tissue lining the nose. Bleeding most often occurs from one nostril only. […] Nosebleeds are very common. Most nosebleeds occur because of minor irritations of the inside of the nostrils or colds. […] Most nosebleeds occur on the front of the nasal septum. This is the piece of the tissue that separates the two sides of the nose. This type of nosebleed can be easy for a trained professional to stop. […] To stop a nosebleed: Sit down and gently squeeze the soft portion of the nose between your thumb and finger (so that the nostrils are closed) for a full 10 minutes. Lean forward to avoid swallowing the blood and breathe through your mouth. Wait at least 10 minutes before checking if the bleeding has stopped. Be sure to allow enough time for the bleeding to stop.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=te8195

  Nosebleeds are common, especially if you have colds or allergies. Many things can cause a nosebleed. […] Some nosebleeds stop on their own with pressure. Others need packing. Some get cauterized (sealed). If you have gauze or other packing materials in your nose, you will need to follow up with your doctor to have the packing removed. You may need more treatment if you get nosebleeds a lot. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] If you get another nosebleed: Gently blow your nose to clear any clots. Sit up and tilt your head slightly forward. This keeps blood from going down your throat. Use your thumb and index finger to pinch the front, soft part of your nose shut for at least 15 minutes. Use a clock. Do not check to see if the bleeding has stopped before the 15 minutes are up. If the bleeding has not stopped, pinch your nose shut for another 10 to 15 minutes. Using a nasal decongestant spray such as oxymetazoline (Drixoral) before pinching your nose can also help to stop the bleeding. Be safe with medicines. Read and follow all instructions on the label.

• #1 Frequent Nosebleed Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/ent-ear-nose-throat/nose-bleeds/treatments

  Frequent nosebleeds can usually be treated at home. Seek medical attention if you are unable to make the bleeding stop on your own. […] Home care for nosebleeds can include: Sitting forward to avoid swallowing blood. Apply pressure to your nose holding both nostrils shut with your thumb and index finger and breathe. Hold position for 10-15 minutes. […] If you seek medical attention, treatment for your nosebleed may include: Packing the nose with gauze to stop bleeding, Medicated nasal spray, Cauterization (burning with an electrical device) of the blood vessel that’s bleeding, Surgery to remove polyps, tumors or otherwise stop the bleeding.

• #1 Nosebleeds: Causes and How To Stop | Red Cross

  https://www.redcross.org/take-a-class/resources/learn-first-aid/nosebleeds?srsltid=AfmBOoqMmbYR4V9gSvVyqca8l8kzGLXN7kJTuw2V9oQITFPkGRIFCIXT

  In most cases, you can stop a nosebleed by having the person pinch his or her nostrils together while sitting with his or her head slightly forward. […] General Care: Nosebleeds […] Have the person pinch their nostrils together while sitting with their head slightly forward. […] This position keeps blood from pooling in the back of the throat, which can lead to choking or vomiting on blood.

• #1 Nosebleeds: Causes, Treatment and Prevention | Brown University Health

  https://www.lifespan.org/be-well/nosebleeds-causes-treatment-and-prevention

  Nosebleeds, also known as epistaxis, are very common, especially in children. […] To stop an active nosebleed, take the following steps: Sit and bend forward slightly at the waist. While it might make sense to lean your head backward, do not lie down or tilt your head back, as this can cause you to swallow blood. Pinch the soft area of your nose below the bone with firm pressure applied to both sides of the nose (even if only one nostril was bleeding). Maintain firm pressure for at least 10 minutes. This may seem like a long time, so use a clock or timer. Do not release the pressure before 10 minutes is up to check, this may prolong the overall bleeding time. Try to stay calm. If you are a caregiver trying to stop a nosebleed in a child, try to use distraction and keep them calm while pinching their nose. If the bleeding does not stop after 10 minutes, try using the same technique but holding pressure for 20-30 minutes straight.

• #1

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=sig56332spec

  Use your thumb and forefinger to firmly pinch the soft part of your nose shut. The nose consists of a hard, bony part and a softer part made of cartilage. Nosebleeds usually occur in the soft part of the nose. Spraying the nose with a decongestant nasal spray like oxymetazoline (Drixoral) before applying pressure may help stop a nosebleed. Be safe with medicines. Read and follow all instructions on the label. You will have to breathe through your mouth. […] Keep pinching for at least 15 minutes. Use a clock to time the 15 minutes. It can seem like a long time. Resist the urge to peek after a few minutes to see if your nose has stopped bleeding. […] Check to see if your nose is still bleeding after 15 minutes. If it is, hold it for 10 to 15 more minutes. Most nosebleeds will stop after 10 to 20 minutes of direct pressure.

• #1 Nosebleed

  https://www2.hse.ie/conditions/nosebleed/

  Do not lie down if you have a nosebleed. […] To help stop a nosebleed: lean forward, pinch the soft part of your nose just above your nostrils for 10 to 15 minutes, breathe through your mouth. […] Placing an ice pack or a bag of frozen vegetables wrapped in a tea towel to your neck or nose or chewing ice may also help reduce the bleeding from your nose. […] There are 2 main treatments that a doctor may use to stop your nose bleeding. […] A doctor will seal where the blood is coming from. They will press a stick with a special chemical on it to stop the bleeding. […] A doctor will pack your nose with sponges to stop the bleeding. You may need to stay in hospital for a day or two. This treatment is used if cautery is not possible.

• #1 Nosebleed Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/nosebleed

  If bleeding persists, a nasal spray decongestant (Afrin, Neo-Synephrine) can sometimes be used to close off small vessels and control bleeding. […] Get emergency care if: Bleeding does not stop after 20 minutes. Nose bleeding occurs after a head injury. This may suggest a skull fracture, and x-rays or other imaging should be taken. […] The type of treatment used will be based on the cause of the nosebleed. Treatment may include: Controlling blood pressure, Closing the blood vessel using heat, electric current, or silver nitrate sticks, Nasal packing, Reducing a broken nose or removing a foreign body, Reducing the amount of blood thinner medicine or stopping aspirin, Treating problems that keeps your blood from clotting normally. […] You may need to see an ear, nose, and throat (ENT, otolaryngologist) specialist for further tests and treatment.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=te8195

  When the bleeding has stopped, try not to pick, rub, or blow your nose for several hours. Avoiding these things helps keep your nose from bleeding again. […] Talk to your doctor about stopping any other medicines you are taking. Some medicines may make you more likely to get a nosebleed. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your nose is still bleeding after you have pinched the nose shut 2 times for 15 minutes each time (30 minutes total). There is a lot of blood running down the back of your throat even after you pinch your nose and tilt your head forward. You feel weak or light-headed. You have a nosebleed after a head injury. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You get nosebleeds often, even if they stop. You do not get better as expected.

• #1 Nosebleeds (Epistaxis): Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis

  Medication adjustments/new prescriptions. Reducing the amount of blood-thinning medications you take or stopping them can be helpful. In addition, medications for managing blood pressure may be necessary. Your provider may prescribe tranexamic (Lysteda), a medication to help blood clot. […] Surgery can repair a broken nose or correct a deviated septum (septoplasty). […] How can I stop a nosebleed at home? Follow these steps to stop a nosebleed: Keep calm and breathe through your mouth. Sit up straight with your head slightly forward. Use your thumb and index finger to pinch the soft sides of your nose (just above your nostrils). Wait for the bleeding to stop. Use a tissue or damp washcloth to catch the blood. […] At-home care is often enough. But some nosebleeds need medical care at a hospital. Have someone drive you to the nearest emergency room or call 911 (or your local emergency service number) if: You can’t stop the bleeding after more than 15 to 20 minutes of pinching your nose. […] Nosebleeds that occur higher on your septum or deeper in your nose may be harder to control. However, nosebleeds are rarely fatal.

• #1 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  Oral and topical antibiotics to prevent rhinosinusitis and possibly toxic shock syndrome […] Avoidance of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) […] Medications to control underlying medical problems (eg, hypertension, vitamin K deficiency) in consultation with other specialists. […] Bleeding from the Kiesselbach plexus (Littles area) is frequently treated with silver nitrate cauterization. […] Manage the vessels leading to the site before managing the actual bleeding site. Avoid random and aggressive cauterization and cautery on opposing surfaces of the septum. […] Electrocauterization with an insulated suction cautery unit can also be used. This method is usually reserved for more severe bleeding and for bleeding in more posteriorly located sites, and it often requires local anesthesia.

• #1 Epistaxis, Nosebleeds – Causes, Types, First Aid | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/nosebleed-epistaxis

  Cauterization with chemicals such as silver nitrate or thermal energy, such as electrocautery, to seal the bleeding blood vessel. The otolaryngologist will administer local anesthetics on the nasal septum to numb the nose before treatment. […] Anterior nasal packing: The otolaryngologist will insert special nasal sponges into the nostrils and press on them to stop the bleeding. The absorbent material will remain for 4872 hours before removal. In some cases, the otolaryngologist may consider using a self-dissolving material without the need to remove it. […] Internal artery ligation: In some cases, the doctor may decide on internal artery ligation or artery occlusion to stop bleeding by using an occlusive tube with nasal endoscopy to tie off a blood vessel to stop bleeding. Endoscopic technology harnesses advanced medical technology to help the doctor to locate the source of bleeding, particularly in the posterior nasal septum, and allow the bleeding to stop quickly.

• #1 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  Ligation of the external carotid artery (ECA) can be performed with the patient under local or general anesthesia. […] Internal maxillary artery ligation has a higher success rate than ECA ligation because of the more distal site of intervention. […] Bleeding from the ECA system may be controlled with embolization, either as a primary modality in poor surgical candidates or as a second-line treatment in those for whom surgery has failed. […] Management of hereditary hemorrhagic telangiectasia (HHT) is palliative because the underlying defect is not curable. Options include coagulation with potassium-titanyl-phosphate (KTP) or neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers, septodermoplasty, embolization, and estrogen therapy. […] Potential treatment complications include the following: Cauterization – Synechia, septal perforation

• #1 Several treatments available for nosebleeds | UCLA Health

  https://www.uclahealth.org/news/article/several-treatments-available-nosebleeds

  Nosebleeds (the medical term is epistaxis) often occur due to physical injury, such as a bump or a fall, or blowing the nose too hard or too often. […] The thrombin spray you were treated with is one of several medications used to encourage what is known as a coagulation cascade. […] When this occurs, cauterization, the treatment your friend underwent, can be helpful. Your ENT will let you know if you are a good candidate. […] Cauterization involves the use of either a chemical swab or an electrical current to seal off the affected blood vessels in the nose. […] Aftercare often includes an ointment to keep the interior of the nose moist and to prevent infection. […] Nosebleed aftercare is important. Always be gentle when blowing your nose. Keep nasal tissues moist with humidifiers.

• #1 Nosebleeds (Epistaxis) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/epistaxis

  Treatments include nasal sprays and sealing off or applying pressure to the bleeding vessel. […] Most nosebleeds can be treated without surgery and without going to the hospital, using one of the following approaches: nasal sprays, topical therapies, cautery, which is a procedure that involves applying heat to seal a bleeding vessel shut, nasal packing, placing a gauze-like material or an inflatable balloon in the nose to put pressure on the bleeding vessel. […] Posterior nosebleeds (toward the back of the nose) and nosebleeds that don’t respond to nonsurgical treatments may require surgery. Minimally invasive surgery can isolate and repair a blood vessel that is the cause of bleeding. […] While a nosebleed is usually a simple problem that can be treated without surgery, some patients’ conditions are complicated. A doctor may need to consider other medical conditions an individual may have, or consider whether the patient is using medications such as blood thinners.

• #1 Management of Epistaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0115/p305.html

  Family physicians frequently encounter patients with epistaxis (nasal bleeding). […] Treatments to be considered include topical vasoconstriction, chemical cautery, electrocautery, nasal packing (nasal tampon or gauze impregnated with petroleum jelly), posterior gauze packing, use of a balloon system (including a modified Foley catheter), and arterial ligation or embolization. […] If local treatments fail to stop anterior bleeding, the anterior nasal cavity should be packed from posterior to anterior with ribbon gauze impregnated with petroleum jelly or antibiotic ointment. […] If a single anterior bleeding site is found, vasoconstriction should be attempted with topical application of a 4 percent cocaine solution or an oxymetazoline or phenylephrine solution. […] When posterior bleeding is suspected, the general location of the source should be determined. […] Posterior bleeding is much less common than anterior bleeding and usually is treated by an otolaryngologist. […] Patients with anterior or posterior bleeding that continues despite packing or balloon procedures may require treatment by an otolaryngologist.

• #1 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  After the bleeding has been controlled, instruct the patient to use nasal saline spray and antibiotic ointment and to avoid strenuous activities for 7-10 days. […] Nasal packing can be used to treat epistaxis that is not responsive to cauterization. […] A study by Kundi and Raza suggested that in patients with epistaxis, removal of nasal packs after 12 hours leads to a lower incidence of headache and excessive lacrimation than does removal of packs after 24 hours, with no significant difference in bleeding recurrence. […] Regardless of the type of posterior pack used, an anterior pack should also be placed. Admit all patients with posterior packing to the intensive care unit (ICU) for close monitoring of oxygenation, fluid status, and pain control. […] The choice of the specific vessel or vessels to be ligated depends on the location of the epistaxis.

• #1 Nosebleed (Epistaxis) – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/nosebleed.html

  Individuals with a nosebleed who require prompt management should receive treatment for active bleeding with firm sustained compression to the lower third of the nose, with or without the assistance of the patient or caregiver, for 5 minutes or longer. […] Individuals in whom bleeding precludes identification of a bleeding site despite nasal compression should receive treatment for active bleeding with nasal packing. […] Individuals with a suspected bleeding disorder or for individuals who are using anticoagulation or antiplatelet medications should receive resorbable packing to manage the nosebleed. Education should be provided about the type of packing placed, timing of, and plan for, removal of packing (if not resorbable), post-procedure care, and any signs or symptoms that would warrant prompt reassessment.

• #1

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=sig56332spec

  Put a thin layer of a saline- or water-based nasal gel, such as NasoGel, or an antiseptic nasal cream inside your nose. Do not blow your nose or put anything else inside your nose for several hours after the bleeding has stopped. […] Rest quietly for a few hours. […] The following tips may prevent a nosebleed from happening. Avoid forceful nose-blowing. Do not pick your nose. Avoid lifting or straining after a nosebleed. Keep your head elevated right after a nosebleed. Put a thin layer of nasal gel or cream inside your nose. Use a saline- or water-based nasal gel, such as NasoGel, or an antiseptic nasal cream. […] Be careful with non-prescription antihistamines, decongestants, or medicated nasal sprays. Nosebleeds may develop in people who have colds or chronic allergy symptoms (post-nasal drip, sneezing, or a runny, stuffy, or itchy nose) because nasal tissues become inflamed and irritated. Using medicines may relieve the symptoms, leading to less inflammation and irritation and fewer nosebleeds. But overuse of allergy medicines may lead to nosebleeds because of their overdrying side effects.

• #1 Nosebleed (Epistaxis) – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/nosebleed.html

  In the absence of life-threatening bleeding, first-line treatments should be used prior to transfusion, reversal of anticoagulation, or withdrawal of anticoagulation/antiplatelet medications for patients using these medications. […] Individuals with a history of recurrent bilateral nosebleeds or family history of nosebleeds should be assessed for presence of nasal telangiectasias and/or oral mucosal telangiectasias in patients who have a history of recurrent bilateral nosebleeds or a family history of recurrent nosebleeds to diagnose hereditary hemorrhagic telangiectasia syndrome. […] Individuals with nosebleeds and their caregivers should receive education about preventive measures for nosebleeds, home treatment for nosebleeds, and indications to seek additional medical care.

• #1 Severe Nosebleed Epistaxis – Causes & Treatment | Mount Sinai – New York

  https://www.mountsinai.org/locations/cerebrovascular-center/conditions/vascular-malformations/severe-nosebleed

  Severe episodes of nosebleeds can be caused by: […] The first step in managing a severe nosebleed involves „packing” the nose, which should be performed by an appropriately trained physician. […] If you experience severe blood loss from a nosebleed, it can cause serious anemia or cardiac dysfunction and reduced quality of life. […] At Mount Sinai, we can use embolization to treat severe, recurring nosebleeds that cannot be controlled by traditional means. […] We may investigate the source of the bleeding via angiography. After we identify the vessels responsible for the bleeding, we can go back in through a catheter and block the vessels to stop the bleeding (embolization). In some cases, this technique can be lifesaving.

• #1 Epistaxis – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/approach-to-the-patient-with-nasal-and-pharyngeal-symptoms/epistaxis

  Posterior bleeding may be difficult to control. Commercial nasal balloons are quick and convenient; a gauze posterior pack is effective but more difficult to place inside the nose. Both are very uncomfortable; IV sedation and analgesia may be needed, and hospitalization is required. […] In hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome), a split-thickness skin graft (septal dermatoplasty) reduces the number of nosebleeds and allows the anemia to be corrected. Laser (Nd:YAG) photocoagulation can be done in the operating room. Selective embolization is also very effective, particularly if patients cannot tolerate general anesthesia or if surgical intervention has not been successful. New endoscopic sinus devices have made transnasal surgery more effective.

• #1 Nosebleed (Epistaxis) – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/nosebleed.html

  Anterior rhinoscopy should be performed to identify a source of bleeding after removal of any blood clot (if present) for individuals with nosebleeds. […] Nasal endoscopy should be performed to identify the site of bleeding and guide further management for individuals with recurrent nasal bleeding, despite prior treatment with packing or cautery, or with recurrent unilateral nasal bleeding. […] Individuals with an identified site of bleeding should be treated with an appropriate intervention, which may include one or more of the following: topical vasoconstrictors, nasal cautery, and moisturizing or lubricating agents. […] Individuals with persistent or recurrent bleeding not controlled by packing or nasal cauterization should be evaluated for candidacy for surgical arterial ligation or endovascular embolization.

• #1 Nosebleeds (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/nose-bleed.html

  Nosebleeds are common in kids 3 to 10 years old, and most are caused by nose-picking or dry air. They can be scary, but usually aren’t serious. Most will stop on their own and can be cared for at home. […] First Aid Guide Nosebleeds Go […] Stay calm and reassure your child. Have your child sit upright in a chair or on your lap, then tilt his or her head slightly forward. Do not have your child lean back. This may cause blood to flow down the back of the throat, which tastes bad and may cause gagging, coughing, or vomiting. Gently pinch the soft part of the nose (just below the bony ridge) with a tissue or clean washcloth. Keep pressure on the nose for about 10 minutes; if you stop too soon, bleeding may start again. Have your child relax a while after a nosebleed. Discourage nose-blowing, picking, or rubbing, and any rough play.

• #1 Nosebleeds (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/nose-bleed.html

  If your child gets nosebleeds more than once a week, call your doctor. Usually, frequent nosebleeds are easily treated. Sometimes tiny blood vessels inside the nose are irritated and don’t heal, which happens more often in kids with ongoing allergies or who get a lot of colds. A doctor might be able to help in these cases. […] Even with proper precautions, kids can still get a bloody nose occasionally. So if your child gets a nosebleed, try not to panic. They’re usually harmless and are almost always easy to stop.

• #1 Nosebleeds: When It’s Time to Get Medical Attention | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/nosebleeds-when-its-time-get-medical-attention

  Frequent nosebleeds are a reason to see a primary care doctor or an ENT (an ear, nose, and throat) specialist, says David A. Gudis, MD, associate professor of otolaryngology/head neck surgery at Columbia University Vagelos College of Physicians Surgeons and chief of the Division of Rhinology Anterior Skull Base Surgery at Columbia University Irving Medical Center/NewYork-Presbyterian Hospital. […] Recurrent nosebleeds can often be managed by simply holding pressure on the nose, but in some cases, medical or surgical intervention is necessary. […] A specialist can rule out a few diagnoses by examination or taking a history. […] If a nosebleed is severe enough that it can fill up a cup with blood, then we are in the territory of something where urgent medical attention is necessary. […] If a patient has frequent nosebleeds, without any other concerning signs or symptoms, topical moisturizing agents for the nose—nasal saline gel spray or a little bit of petroleum jelly in the front of the nose—can protect the lining of the nose and minimize nosebleeds.

• #1 Epistaxis (Nosebleed) Management – CureHHT

  https://hhtguidelines.org/epistaxis/

  A1: The expert panel recommends that patients with HHT-related epistaxis use moisturizing topical therapies that humidify the nasal mucosa to reduce epistaxis. […] A2: The expert panel recommends that clinicians consider the use of oral tranexamic acid for the management of epistaxis that does not respond to moisturizing topical therapies. […] A3: The expert panel recommends that clinicians should consider ablative therapies for nasal telangiectasias including laser treatment, radiofrequency, electrosurgery, and sclerotherapy in patients that have failed to respond to moisturizing topical therapies. […] A4: The expert panel recommends that clinicians consider the use of systemic antiangiogenic agents for the management of epistaxis that has failed to respond to moisturizing topical therapies, ablative therapies and/or tranexamic acid.

• #1 Laser Treatment for Nosebleeds: When Is It Likely to Work? – CureHHT

  https://curehht.org/research_project/laser-treatment-nosebleeds-likely-work/

  Finally, 80% of patients with pattern III demonstrated a good response to the Nd-YAG laser photocoagulation treatment. […] These findings are important for physicians caring for HHT patients as they may help to predict response to laser therapy. […] For example, when a patient with HHT is noted to have isolated intranasal telangiectases, he or she can be counseled to anticipate a good response to Nd-YAG laser photocoagulation, while patients with a more diffuse vascular pattern almost uniformly have a sub-optimal response to their Nd-YAG laser treatments. […] For patients with patterns I and III, treatment with the Nd-YAG laser will typically provide an improvement in the intensity and frequency of epistaxis for a minimum of six months. […] The procedure is simple, requires only local anesthesia with sedation, and has few risks or side-effects. […] To conclude, the findings in this study will allow otolaryngologists to better counsel HHT patients and improve stratification for therapy.

• #1 Nosebleeds – ENT Health

  https://www.enthealth.org/conditions/nosebleeds/

  What Are the Treatment Options? […] It is important to try to determine if the nosebleed is anterior or posterior. Posterior nosebleeds are often more severe and almost always require a physicians care. […] Anterior nosebleedsWhen dry air is believed to be the cause of the nosebleed, it may result in crusting, cracking, and bleeding. This can be prevented by placing a light coating of saline gel, petroleum jelly, or an antibiotic ointment on the end of a Q-tip and gently applying it inside the nose, especially on the middle portion of the nose (the septum). […] Should the bleeding continue after this, you should seek medical care. Treatment administered by a medical professional at this point may include cautery (a technique in which the blood vessel is burned with an electric current, silver nitrate, or a laser to stop the blood flow) or nasal packing.

• #1 Epistaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK435997/

  Formal posterior nasal packing should only be performed by experienced personnel as it requires admission, telemetry monitoring, and sometimes intubation; this is associated with higher rates of complications like pressure necrosis, infection, or hypoxia. […] If these measures are unsuccessful, the patient should be intubated for airway protection, and interventional radiology should be consulted emergently for embolization. […] Once the bleeding is controlled, arranging a timely follow-up (within 1 week) with their primary care clinician or an otolaryngologist is essential. […] Patients should also be advised to avoid hot foods, strenuous activity, blowing the nose, or digital manipulation of the nose on discharge. […] An interprofessional team best performs the care of nose bleeding.

• #2 Nosebleed Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/nosebleed

  A nosebleed is loss of blood from the tissue lining the nose. Bleeding most often occurs from one nostril only. […] Nosebleeds are very common. Most nosebleeds occur because of minor irritations of the inside of the nostrils or colds. […] Most nosebleeds occur on the front of the nasal septum. This is the piece of the tissue that separates the two sides of the nose. This type of nosebleed can be easy for a trained professional to stop. […] To stop a nosebleed: Sit down and gently squeeze the soft portion of the nose between your thumb and finger (so that the nostrils are closed) for a full 10 minutes. Lean forward to avoid swallowing the blood and breathe through your mouth. Wait at least 10 minutes before checking if the bleeding has stopped. Be sure to allow enough time for the bleeding to stop.

• #2 Nosebleeds: Causes, Treatment and Prevention | Brown University Health

  https://www.lifespan.org/be-well/nosebleeds-causes-treatment-and-prevention

  Nosebleeds, also known as epistaxis, are very common, especially in children. […] To stop an active nosebleed, take the following steps: Sit and bend forward slightly at the waist. While it might make sense to lean your head backward, do not lie down or tilt your head back, as this can cause you to swallow blood. Pinch the soft area of your nose below the bone with firm pressure applied to both sides of the nose (even if only one nostril was bleeding). Maintain firm pressure for at least 10 minutes. This may seem like a long time, so use a clock or timer. Do not release the pressure before 10 minutes is up to check, this may prolong the overall bleeding time. Try to stay calm. If you are a caregiver trying to stop a nosebleed in a child, try to use distraction and keep them calm while pinching their nose. If the bleeding does not stop after 10 minutes, try using the same technique but holding pressure for 20-30 minutes straight.

• #2

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=sig56332spec

  Use your thumb and forefinger to firmly pinch the soft part of your nose shut. The nose consists of a hard, bony part and a softer part made of cartilage. Nosebleeds usually occur in the soft part of the nose. Spraying the nose with a decongestant nasal spray like oxymetazoline (Drixoral) before applying pressure may help stop a nosebleed. Be safe with medicines. Read and follow all instructions on the label. You will have to breathe through your mouth. […] Keep pinching for at least 15 minutes. Use a clock to time the 15 minutes. It can seem like a long time. Resist the urge to peek after a few minutes to see if your nose has stopped bleeding. […] Check to see if your nose is still bleeding after 15 minutes. If it is, hold it for 10 to 15 more minutes. Most nosebleeds will stop after 10 to 20 minutes of direct pressure.

• #2 How To Stop & Prevent Nosebleeds

  https://www.webmd.com/first-aid/nosebleeds-causes-and-treatments

  Nosebleeds usually arent serious. You can treat most by yourself at home by doing the following: Stay calm. If you start to get nervous, it can actually make you bleed more. Try to relax. Sit up, dont lie down. Keep your head above your heart. Lean a little bit forward. This keeps the blood from draining down the back of your throat. Pinch your nostrils closed. Use your thumb and index finger to hold your nostrils closed for 5 to 10 minutes while you breathe through your mouth. This puts pressure on the part of your nose thats bleeding and can make the blood stop flowing. […] Once the bleeding has stopped, do not touch or blow your nose. This may start it bleeding again. But if it does restart, gently blow your nose to get rid of any blood clots. You can also spray a decongestant such as oxymetazoline (Afrin, Mucinex, or Vicks Sinex) in both nostrils. Then pinch your nostrils shut and breathe through your mouth for 5 to 10 minutes.

• #2 Nosebleed (Epistaxis) in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/n/nosebleed-epistaxis-in-children.html

  You may also put a cold compress on the bony bridge of the nose. Wrap cold compresses in a thin towel. Do not put them directly on the skin. […] Once the bleeding stops, tell your child not to rub, pick, or blow their nose for 2 to 3 days. This will let the broken blood vessel heal. […] If the bleeding doesn’t stop, contact your child’s healthcare provider right away or go to the emergency room or urgent care clinic. […] In some cases, a provider may apply a chemical or heat to close a blood vessel. This is called cauterization. The provider may pack the nose as another option. Both are quick procedures. Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

• #2 Home Remedies: 4 steps to stop a nosebleed – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/home-remedies-4-steps-to-stop-a-nosebleed/

  Most nosebleeds aren’t serious and will stop on their own or by following self-care steps. […] Talk to your health care provider if you’re having frequent nosebleeds, even if you can stop them fairly easily. It’s important to determine the cause of frequent nosebleeds. […] Self-care steps for occasional nosebleeds include: Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. […] Pinch your nose. Use your thumb and index finger to pinch both nostrils shut, even if only one side is bleeding. Breathe through your mouth. Continue to pinch for five to 10 minutes. This maneuver puts pressure on the bleeding point on the nasal septum and often stops the flow of blood. […] After the bleeding has stopped, to keep it from starting again, don’t pick or blow your nose and don’t bend down for several hours. Keep your head higher than the level of your heart

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=te8195

  When the bleeding has stopped, try not to pick, rub, or blow your nose for several hours. Avoiding these things helps keep your nose from bleeding again. […] Talk to your doctor about stopping any other medicines you are taking. Some medicines may make you more likely to get a nosebleed. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your nose is still bleeding after you have pinched the nose shut 2 times for 15 minutes each time (30 minutes total). There is a lot of blood running down the back of your throat even after you pinch your nose and tilt your head forward. You feel weak or light-headed. You have a nosebleed after a head injury. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You get nosebleeds often, even if they stop. You do not get better as expected.

• #2 Nosebleeds (Epistaxis) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/epistaxis

  Treatments include nasal sprays and sealing off or applying pressure to the bleeding vessel. […] Most nosebleeds can be treated without surgery and without going to the hospital, using one of the following approaches: nasal sprays, topical therapies, cautery, which is a procedure that involves applying heat to seal a bleeding vessel shut, nasal packing, placing a gauze-like material or an inflatable balloon in the nose to put pressure on the bleeding vessel. […] Posterior nosebleeds (toward the back of the nose) and nosebleeds that don’t respond to nonsurgical treatments may require surgery. Minimally invasive surgery can isolate and repair a blood vessel that is the cause of bleeding. […] While a nosebleed is usually a simple problem that can be treated without surgery, some patients’ conditions are complicated. A doctor may need to consider other medical conditions an individual may have, or consider whether the patient is using medications such as blood thinners.

• #2 Nosebleeds: First aid

  https://www.mayoclinic.org/first-aid/first-aid-nosebleeds/basics/art-20056683

  Nosebleeds, also called epistaxis (ep-ih-STAK-sis), are common. They happen when the tender blood vessels in the nose break. Common nosebleed causes can include changes of season, dryness, scratching, some medicines and injuries. People on blood thinners may have worse nosebleeds than do others. Most often nosebleeds are only annoying and not a true medical problem. But they can be both. […] Follow these steps to treat a common nosebleed. […] Pinching puts pressure on the blood vessels and helps stop the blood flow. […] If the bleeding doesn’t stop, pinch the nose again for up to 15 minutes. […] Seek emergency care if the bleeding doesn’t stop after the second try. […] You may need to have a blood vessel cauterized. Cautery is a method that burns and seals blood vessels using electric current, silver nitrate or a laser. […] A care provider might pack the nose with special gauze or an inflatable latex balloon. Both packing methods put pressure on the blood vessel and stop the bleeding. […] Think about using a humidifier. Adding more moisture in your home may help relieve nasal bleeding.

• #2 The ENT Center | Nosebleeds – Causes and Treatments

  https://stamfordentcenter.com/epistaxis-nosebleeds/

  the adjustment of medications […] retrieval of foreign bodies that may have been stuck up the nose […] surgery (when dealing with a deviated septum or broken nose) […] treatment to stem the bleeding, such as nasal packing or cauterizing the nose. […] If your ENT determines that frequent anterior nosebleeds are caused by an irritated blood vessel, he or she may suggest cauterizing the nose. Cauterization burns the irritated blood vessel to seal it close. For this procedure, the ENT typically applies chemical cauterization using silver nitrate. Silver nitrate cauterization can be done safely in the clinic while you are awake. After numbing the area with topical lidocaine, the physician touches the affected blood vessel with a silver nitrate stick for several seconds until it seals closed.

• #2 Laser Treatment for Nosebleeds: When Is It Likely to Work? – CureHHT

  https://curehht.org/research_project/laser-treatment-nosebleeds-likely-work/

  Over the years, a wide variety of treatments have been used to help manage nosebleeds in HHT patients including electro-cauterization, nasal packing, septodermoplasty (see article herein), arterial embolization, arterial ligation, and hormone therapy. […] recent attention has focused on the use of lasers for the treatment of intranasal telangiectases in patients with HHT. […] Patient responses to therapy were evaluated. Patients were identified as a responder to the Nd-YAG laser treatment if they noted a 50% decrease in the severity and frequency of their nosebleeds for a period of greater than 6 months. […] Interestingly, vascular pattern I was most common, while vascular pattern III was least common. Patients with vascular pattern I uniformly demonstrated a good response to the Nd-YAG laser.

• #2 Managing Recurrent Epistaxis with Nasal Cautery – Advances in Otolaryngology – Head and Neck Surgery | NewYork-Presbyterian

  https://www.nyp.org/advances/article/ent/managing-recurrent-epistaxis-with-nasal-cautery

  Recurrent nosebleeds can often be managed by simply holding pressure on the nose. In some cases medical or surgical intervention is necessary, notes Dr. Gudis. […] Cauterization with topical silver nitrate is generally the treatment of choice for anterior epistaxis. […] If home remedies dont work or the nosebleeds are troublesome, an application of silver nitrate can put a stop to the nosebleed. Silver nitrate is a chemical that has been used in medicine for hundreds of years for many different purposes, and one thing it does very well is cause sclerosis of blood vessels, says Dr. Gudis. […] Nasal cauterization can be performed in the office, but for those patients who are unable to follow instructions or who cannot tolerate brief discomfort, the procedure is best performed in the emergency department, adds Dr. Gudis. […] Dr. Gudis emphasizes that when performed in a conscious patient who is able to follow instructions, cauterization with silver nitrate is a straightforward procedure in managing recurrent epistaxis.

• #2 Nosebleed: Causes, Treatment, and Prevention – Skinsight

  https://skinsight.com/skin-conditions/first-aid-nosebleed/

  Most nosebleeds are not a medical emergency and can be treated with basic first aid measures. […] The following self-care measures for nosebleeds are recommended: Have the person with the nosebleed sit upright and lean forward and breathe out of their mouth, and have them try to keep calm. They should also keep their head above their heart. […] Firmly pinch the soft part of the nose, and place a cold compress on the bridge of the nose. This should be done continuously for 10-15 minutes. Do not release the pressure on the nose. […] If the nose is still bleeding after repeating the above steps once more, seek medical care. […] The medical professional may pack the nose with gauze or an inflatable latex balloon to properly put pressure on the blood vessels to stop the bleeding. […] If you have frequent nosebleeds, your medical professional may perform cautery on the blood vessels with electric current, silver nitrate, or a laser on the inside of the nostril causing the problem.

• #2 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  After the bleeding has been controlled, instruct the patient to use nasal saline spray and antibiotic ointment and to avoid strenuous activities for 7-10 days. […] Nasal packing can be used to treat epistaxis that is not responsive to cauterization. […] A study by Kundi and Raza suggested that in patients with epistaxis, removal of nasal packs after 12 hours leads to a lower incidence of headache and excessive lacrimation than does removal of packs after 24 hours, with no significant difference in bleeding recurrence. […] Regardless of the type of posterior pack used, an anterior pack should also be placed. Admit all patients with posterior packing to the intensive care unit (ICU) for close monitoring of oxygenation, fluid status, and pain control. […] The choice of the specific vessel or vessels to be ligated depends on the location of the epistaxis.

• #2 Epistaxis, Nosebleeds – Causes, Types, First Aid | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/nosebleed-epistaxis

  Cauterization with chemicals such as silver nitrate or thermal energy, such as electrocautery, to seal the bleeding blood vessel. The otolaryngologist will administer local anesthetics on the nasal septum to numb the nose before treatment. […] Anterior nasal packing: The otolaryngologist will insert special nasal sponges into the nostrils and press on them to stop the bleeding. The absorbent material will remain for 4872 hours before removal. In some cases, the otolaryngologist may consider using a self-dissolving material without the need to remove it. […] Internal artery ligation: In some cases, the doctor may decide on internal artery ligation or artery occlusion to stop bleeding by using an occlusive tube with nasal endoscopy to tie off a blood vessel to stop bleeding. Endoscopic technology harnesses advanced medical technology to help the doctor to locate the source of bleeding, particularly in the posterior nasal septum, and allow the bleeding to stop quickly.

• #2 Epistaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK435997/

  Formal posterior nasal packing should only be performed by experienced personnel as it requires admission, telemetry monitoring, and sometimes intubation; this is associated with higher rates of complications like pressure necrosis, infection, or hypoxia. […] If these measures are unsuccessful, the patient should be intubated for airway protection, and interventional radiology should be consulted emergently for embolization. […] Once the bleeding is controlled, arranging a timely follow-up (within 1 week) with their primary care clinician or an otolaryngologist is essential. […] Patients should also be advised to avoid hot foods, strenuous activity, blowing the nose, or digital manipulation of the nose on discharge. […] An interprofessional team best performs the care of nose bleeding.

• #2 Epistaxis – Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/epistaxis-treatment/

  Clinical pitfalls: […] Inadequate analgesia. […] Using on both sides of the nasal septum (risk of ulceration/perforation). […] Not waiting 4-6 weeks to try again (risk of ulceration/perforation). […] Start on surrounding area and then on source itself. Roll over area 5-10 seconds. […] Sealants, nasal packing and/or topical tranexamic acid (TXA): […] If conservative measures (steps 1-3) ineffective: Aliem.com […] Posterior Epistaxis: […] Consult ENT. […] Posterior packing: […] Temporizing measure due to higher complication rates. […] Other Treatments: […] Warm water irrigation for refractory epistaxis: […] If patient anticoagulated: […] Resorbable packing (e.g. Surgicel) preferred, to avoid rebleeding during removal. […] TXA may be beneficial as alternative or adjunct to packing.

• #2 Nosebleed Causes, Warning Signs, When to Worry, How To Stop

  https://www.medicinenet.com/nosebleed/article.htm

  What is the treatment for nosebleeds? […] Most people who develop nose bleeding can handle the problem without the need for treatment by a healthcare professional if they follow the step-by-step first aid recommendations below on how to stop a nosebleed: […] If the nosebleed persists or is recurrent, see your healthcare professional who may recommend stopping the nosebleed with a heating instrument or chemical swab (cautery of the blood vessel that is causing the trouble), or application of a topical medicine called thrombin that promotes local clotting of blood. Blood tests may be ordered to check for bleeding disorders. If bleeding is still persistent, the doctor may place nasal packs, which compress the vessels and stop the bleeding. […] Nasal packs are used when less conservative measures fail. These packs are frequently placed on both sides of the nose. The packs are usually made of a material called „Merocel” which is a compressed sponge-like material or a gel gauze-wrapped balloon (called a „Rhino Rocket”) used to help compress the area of the nose that is bleeding. The doctor usually leaves them in for several days. This requires a follow-up appointment so your doctor can remove the packs.

• #2 Nosebleed Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/nosebleed

  If bleeding persists, a nasal spray decongestant (Afrin, Neo-Synephrine) can sometimes be used to close off small vessels and control bleeding. […] Get emergency care if: Bleeding does not stop after 20 minutes. Nose bleeding occurs after a head injury. This may suggest a skull fracture, and x-rays or other imaging should be taken. […] The type of treatment used will be based on the cause of the nosebleed. Treatment may include: Controlling blood pressure, Closing the blood vessel using heat, electric current, or silver nitrate sticks, Nasal packing, Reducing a broken nose or removing a foreign body, Reducing the amount of blood thinner medicine or stopping aspirin, Treating problems that keeps your blood from clotting normally. […] You may need to see an ear, nose, and throat (ENT, otolaryngologist) specialist for further tests and treatment.

• #2 Nosebleed – Wikipedia

  https://en.wikipedia.org/wiki/Nosebleed

  When attempting to stop a nosebleed at home, the head should not be tilted back. […] Vasoconstrictive medications such as oxymetazoline (Afrin) or phenylephrine are widely available over the counter for treatment of allergic rhinitis and may also be used to control benign cases of epistaxis. […] For example, a few sprays of oxymetazoline may be applied into the bleeding side(s) of the nose followed by application of direct pressure. […] Those with nosebleeds that last longer than 30 minutes (despite use of direct pressure and vasoconstrictive medications such as oxymetazoline) should seek medical attention. […] This method involves applying a chemical such as silver nitrate to the nasal mucosa, which burns and seals off the bleeding. […] If pressure and chemical cauterization cannot stop bleeding, nasal packing is the mainstay of treatment.

• #2 Nosebleeds: Causes, Treatment and Prevention | Brown University Health

  https://www.lifespan.org/be-well/nosebleeds-causes-treatment-and-prevention

  In people who get frequent or recurrent nosebleeds, sometimes medications may be appropriate to help treat them when they happen. These can include over-the-counter nasal sprays or prescription medications. Talk to your doctor to see what is right for you. […] There are several things that can be done to prevent nosebleeds or reduce the frequency of nosebleeds. These include: Use of a cool mist humidifier in the home, especially nearby when sleeping. This is particularly helpful when the air is dry, such as in the winter. Reduce allergen exposure, or treat allergies with appropriate medication if recommended by your doctor. Keep the inside of your nose moisturized by using nasal saline sprays or gels twice daily. Avoid picking your nose. Avoid smoke exposure. […] Most of the time, nosebleeds will stop on their own or will respond well to applying pressure as described above. However, there are some situations where seeking medical care is required, including: Bleeding does not stop after 30 minutes of applying direct pressure to the nose. You feel faint or lightheaded. You have other bleeding symptoms, including bruising. You are taking blood thinner medications. There is trauma or injury to the face along with the nosebleed. There is a foreign object in your nose. You experience nosebleeds often. If you experience any of these symptoms, please seek medical attention. Healthcare providers have the tools to help stop the bleeding and can be sure there are no other complications.

• #2 Nosebleed Causes, Warning Signs, When to Worry, How To Stop

  https://www.medicinenet.com/nosebleed/article.htm

  The usage of nasal packs may result in complications. While the packs are in place, oral antibiotics are frequently recommended as a preventative step against toxic shock syndrome. […] The most common cause of nosebleeds is the drying of the nasal membranes. If a person is prone to recurrent or frequent nosebleeds, it is often helpful to lubricate the nose with an ointment of some type. The ointment can be applied gently with a cotton swab or fingertip up inside the nose, especially on the middle portion (the septum). […] Your doctor may recommend some form of lubricating ointment for the inside of the nose.

• #2 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  Ligation of the external carotid artery (ECA) can be performed with the patient under local or general anesthesia. […] Internal maxillary artery ligation has a higher success rate than ECA ligation because of the more distal site of intervention. […] Bleeding from the ECA system may be controlled with embolization, either as a primary modality in poor surgical candidates or as a second-line treatment in those for whom surgery has failed. […] Management of hereditary hemorrhagic telangiectasia (HHT) is palliative because the underlying defect is not curable. Options include coagulation with potassium-titanyl-phosphate (KTP) or neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers, septodermoplasty, embolization, and estrogen therapy. […] Potential treatment complications include the following: Cauterization – Synechia, septal perforation

• #2 Nosebleed (Epistaxis) – Harvard Health

  https://www.health.harvard.edu/a_to_z/nosebleed-epistaxis-a-to-z

  Nosebleeds usually involve one nostril, but occasionally both nostrils are involved. […] If you are bleeding from the front of your nose, begin by trying the following first-aid measures: Sit up (so your head is above the level of your heart), lean forward slightly and breathe through your mouth. With your thumb and index finger, pinch the entire front of your nose (just above your nostrils and below the hard, bony base) and hold for five minutes. […] When simple first aid does not stop a nosebleed, your doctor may treat the problem by: Applying medication directly to the inside of your nose to stop the bleeding, Sealing off (cauterizing) the injured blood vessel with a chemical, such as silver nitrate, or with an electric probe, Packing your nose with gauze or a sponge, Using other methods, such as: Laser therapy – A laser beam seals the bleeding blood vessel, Embolization – A special plug inserted into the bleeding vessel blocks blood flow, Surgery – Ties off a selection of blood vessels.

• #2 Epistaxis, Nosebleeds – Causes, Types, First Aid | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/nosebleed-epistaxis

  Medication adjustments or new prescriptions: Some medications contain anticoagulants. Therefore, in patients with congenital diseases, the otolaryngologist may consider adjusting the existing medications or using a new drug to help control blood pressure, or prescribing an anticoagulant, such as Tranexamic, to help with the blood clot. […] Surgical repair of a broken nose or correction of a deviated nasal septum: In patients with a broken nose or a deviated septum, the doctor may consider surgery to stop nosebleeds, repair the broken nose, or reposition a deviated nasal septum. The anesthesiologist will administer anesthesia before surgery. […] Foreign body removal: Many epistaxes are caused by children accidentally putting toys or foreign objects into their noses, resulting in nosebleeds. The doctor will examine the nose to see if there are foreign bodies, and their removal will help stop the bleeding for good.

• #2 Epistaxis (Nosebleed) Management – CureHHT

  https://hhtguidelines.org/epistaxis/

  A5: The expert panel recommends that clinicians consider a septodermoplasty for patients whose epistaxis has failed to respond sufficiently to moisturizing topical therapies, ablative therapies, and/or tranexamic acid. […] A6: The expert panel recommends that clinicians consider a nasal closure for patients whose epistaxis has failed to respond sufficiently to moisturizing topical therapies, ablative therapies, and/or tranexamic acid. […] A7: The expert panel recommends that physicians advise patients with HHT-related epistaxis to use agents that humidify the nasal mucosa to prevent epistaxis. […] A8: The expert panel recommends that clinicians refer HHT patients with epistaxis and who desire treatment to otorhinolaryngologists with HHT expertise for evaluation and treatment. […] A10: The expert panel recommends that the treatment for acute epistaxis requiring intervention include packing with material or products that have a low likelihood of causing re-bleeding with removal (e.g., lubricated low-pressure pneumatic packing).

• #2 Nosebleeds | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/nosebleeds

  Bleeding from the nose is common in children and is usually not a sign of any underlying problem. […] First aid treatment includes pinching the nostrils until the bleeding stops. […] If the nosebleed wont stop, see a doctor or go to a hospital emergency department. […] To manage a nosebleed include: Reassure the person, especially children, as crying increases blood flow. […] Apply finger and thumb pressure on the soft part of nostrils below the bridge of the nose for at least 10 minutes. […] If bleeding persist, seek medical aid. […] You should go to the doctor or a hospital emergency department if the bleeding does not stop after simple first aid management. […] If your child keeps having nosebleeds, see your doctor as the cause needs to be understood and treatment commenced.

• #2 Nosebleeds (Epistaxis): Causes, Prevention and How to Treat | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/nosebleeds

  Nosebleeds can be treated at home […] Nationwide Children’s Hospital offers a team of experts focused on the treatment of children with nosebleeds. […] Call your child’s health care provider if bleeding does not stop after a total of 10 minutes of pinching the nostrils. […] Smear a very thin coat of nasal ointment inside each nostril 2 to 3 times a day, especially at bedtime, for 2 weeks during the dry season. […] If your child takes aspirin, an anticoagulant (anti-clotting) medicine or uses nasal sprays for allergies, be sure to tell the health care provider how often the nosebleeds happen. […] The nosebleed does not stop after 10 minutes of pressure.

• #2 How to Stop a Public Nosebleed (or at Home)

  https://www.verywellhealth.com/how-to-stop-a-nosebleed-8608417

  If your nosebleed is still heavy after 15 to 20 minutes of pinching the nose, see a healthcare provider, such as at an urgent care clinic. […] Blood thinners, also known as anticoagulant medication, are used to treat and prevent blood clots. People who are on anticoagulant therapy are at higher risk for bleeding in general, including nosebleeds. […] Nosebleeds are one of the more common side effects of anticoagulant medications. […] If you are on anticoagulant therapy and getting nosebleeds, tell your provider. […] If there is no underlying condition causing your nosebleeds, there are still ways you can help reduce the risk of frequent nosebleeds, including: Use a humidifier at home and/or at work to maintain the moisture in the air around you. […] Most nosebleeds will stop within 15 minutes or so. However, certain underlying medical conditions, lifestyle behaviors, or medications may increase the risks of severe nosebleeds that are more challenging to stop. […] If bleeding continues and doesn’t lessen, seek medical care. Go to the emergency room if you are dizzy, light-headed, or short of breath.

• #2 Nosebleeds From Chemo: 3 Ways To Stop a Bloody Nose | MyBCTeam

  https://www.mybcteam.com/resources/nosebleeds-from-chemo-ways-to-stop-a-bloody-nose

  Have you been getting nosebleeds during chemotherapy (chemo) and wonder if the two are related? […] Chemotherapy drugs like Taxol and nosebleeds can sometimes go hand in hand. Chemo can destroy platelets cells that form blood clots to help stop bleeding which can lead to thrombocytopenia (a low platelet count) and make you more susceptible to bleeding, especially nosebleeds. […] Here are three ways to stop nosebleeds that might come with chemo. […] If pinching your nose doesn’t stop the bleeding after 10 minutes, you can also try applying an ice pack or cold compress to the bridge (bony part) of your nose. […] Another way to stop a bloody nose is to use a decongestant spray in the side of your nose that’s bleeding. […] Talk to your health care team about prevention tips for nosebleeds from chemo and any over-the-counter treatments they may recommend for keeping your nose from becoming too dry.

• #2 Epistaxis (Nosebleed) Management – CureHHT

  https://hhtguidelines.org/epistaxis/

  A1: The expert panel recommends that patients with HHT-related epistaxis use moisturizing topical therapies that humidify the nasal mucosa to reduce epistaxis. […] A2: The expert panel recommends that clinicians consider the use of oral tranexamic acid for the management of epistaxis that does not respond to moisturizing topical therapies. […] A3: The expert panel recommends that clinicians should consider ablative therapies for nasal telangiectasias including laser treatment, radiofrequency, electrosurgery, and sclerotherapy in patients that have failed to respond to moisturizing topical therapies. […] A4: The expert panel recommends that clinicians consider the use of systemic antiangiogenic agents for the management of epistaxis that has failed to respond to moisturizing topical therapies, ablative therapies and/or tranexamic acid.

• #2 Nosebleeds – epistaxis, treatments and prevention | healthdirect

  https://www.healthdirect.gov.au/nosebleed

  If your nosebleeds persist and become a problem, you may need further treatment. The treatment might be surgery to close off the blood vessels in the nose. Talk to your doctor about your options. […] In some cases, nosebleeds can be prevented. It depends on the cause. […] You can help prevent some nosebleeds by: not picking your nose, blowing your nose gently, using a humidifier and putting a small amount of lubricant, such as petroleum jelly (Vaseline), inside your nostrils to prevent them drying out.

• #2 Nosebleeds – ENT Health

  https://www.enthealth.org/conditions/nosebleeds/

  Posterior nosebleeds are more likely to occur in older people and people with previous nasal or sinus surgery or injury to the nose or face. Generally, treatment includes cautery and/or packing the nose. […] Frequent nosebleedsIf frequent nosebleeds are a problem, it is important to consult an ENT (ear, nose, and throat) specialist, or otolaryngologist, who will carefully examine the nose using an endoscope (a pencil-sized scope) to see inside the nose before making a treatment recommendation.

• #2 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  Anterior packing – Synechia, rhinosinusitis, toxic shock syndrome, eustachian tube dysfunction, scarring of the nasal ala and columella […] Posterior packing – Synechia, rhinosinusitis, toxic shock syndrome, eustachian tube dysfunction, dysphagia, scarring of nasal ala and columella, hypoventilation, sudden death […] Transantral internal maxillary artery ligation – Anesthetic risks, rhinosinusitis, oroantral fistula, infraorbital numbness, dental injury […] Transoral internal maxillary artery ligation – Anesthetic risks, cheek numbness, trismus, tongue paresthesia […] Anterior or posterior ethmoidal artery ligation – Anesthetic risks, rhinosinusitis, lacrimal duct injury, telecanthus, blindness […] Embolization – Facial pain, trismus, facial paralysis, skin necrosis, blindness, stroke, groin hematoma.

• #2 Nosebleed (Epistaxis) – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/nosebleed.html

  Individuals with a nosebleed who require prompt management should receive treatment for active bleeding with firm sustained compression to the lower third of the nose, with or without the assistance of the patient or caregiver, for 5 minutes or longer. […] Individuals in whom bleeding precludes identification of a bleeding site despite nasal compression should receive treatment for active bleeding with nasal packing. […] Individuals with a suspected bleeding disorder or for individuals who are using anticoagulation or antiplatelet medications should receive resorbable packing to manage the nosebleed. Education should be provided about the type of packing placed, timing of, and plan for, removal of packing (if not resorbable), post-procedure care, and any signs or symptoms that would warrant prompt reassessment.

• #3 Nosebleeds | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/nosebleeds

  Bleeding from the nose is common in children and is usually not a sign of any underlying problem. […] First aid treatment includes pinching the nostrils until the bleeding stops. […] If the nosebleed wont stop, see a doctor or go to a hospital emergency department. […] To manage a nosebleed include: Reassure the person, especially children, as crying increases blood flow. […] Apply finger and thumb pressure on the soft part of nostrils below the bridge of the nose for at least 10 minutes. […] If bleeding persist, seek medical aid. […] You should go to the doctor or a hospital emergency department if the bleeding does not stop after simple first aid management. […] If your child keeps having nosebleeds, see your doctor as the cause needs to be understood and treatment commenced.

• #3 Home Remedies: 4 steps to stop a nosebleed – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/home-remedies-4-steps-to-stop-a-nosebleed/

  Most nosebleeds aren’t serious and will stop on their own or by following self-care steps. […] Talk to your health care provider if you’re having frequent nosebleeds, even if you can stop them fairly easily. It’s important to determine the cause of frequent nosebleeds. […] Self-care steps for occasional nosebleeds include: Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. […] Pinch your nose. Use your thumb and index finger to pinch both nostrils shut, even if only one side is bleeding. Breathe through your mouth. Continue to pinch for five to 10 minutes. This maneuver puts pressure on the bleeding point on the nasal septum and often stops the flow of blood. […] After the bleeding has stopped, to keep it from starting again, don’t pick or blow your nose and don’t bend down for several hours. Keep your head higher than the level of your heart

• #3 How To Stop a Nosebleed

  https://health.clevelandclinic.org/how-to-stop-a-nosebleed

  At this point, youve probably already grabbed about 20 tissues or so. Thats fine and good, but Dr. Chaaban also recommends a straight posture. Thats right, the best thing to stop a nosebleed is to remain vertical. […] Youll need a couple of extra tissues for this one. Use your thumb and index finger to pinch together the soft part of your nose. Make sure to pinch the soft part of the nose against the middle part of the nose (septum). Squeezing at or above the bony part of your nose wont put pressure where it can help stop the bleeding. […] This pinch method works by directly compressing the blood vessels in the front part of your nasal septum, an area rich with blood vessels and the usual source of nosebleeds. […] After 10 to 15 minutes of applying steady pressure, release gently and check if the bleeding has stopped. If it hasnt, gently pinch again for another 10 minutes. If youre taking a blood thinner, you may need to pinch your nose for a longer time.

• #3 Nosebleeds | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/ear-nose-throat/nosebleeds

  Fortunately, there are some easy steps you can take to prevent and treat most nosebleeds on your own at home. […] Nosebleeds are rarely dangerous and can be easily managed at home if you know what to do and when to seek help. […] Apply 3 sprays of decongestant nose spray, such as Afrin, into the side that is bleeding. […] Pinch the soft part of your nose shut. […] Pinch the nose for 10 minutes. Use a clock to keep track of time. […] After 10 minutes, let go of your nose. If it is still bleeding, soak a cotton ball with the nose spray. Place the cotton ball into the bleeding nostril and pinch for 10 minutes. […] Once bleeding has stopped, do not blow your nose for 2 days. […] Check your blood pressure, if possible. High blood pressure can cause nosebleeds. […] Nosebleeds are a nuisance but rarely an emergency. There are some situations, however, when nosebleeds require immediate medical attention: Bleeding that does not stop in 30 minutes. […] We have expertise in treating all forms of nosebleeds, including those caused by hereditary conditions. […] If you take anticoagulation medication and experience frequent/more severe nosebleeds, call us for an urgent appointment.

• #3 Nosebleeds: Causes, Treatment and Prevention | Brown University Health

  https://www.lifespan.org/be-well/nosebleeds-causes-treatment-and-prevention

  In people who get frequent or recurrent nosebleeds, sometimes medications may be appropriate to help treat them when they happen. These can include over-the-counter nasal sprays or prescription medications. Talk to your doctor to see what is right for you. […] There are several things that can be done to prevent nosebleeds or reduce the frequency of nosebleeds. These include: Use of a cool mist humidifier in the home, especially nearby when sleeping. This is particularly helpful when the air is dry, such as in the winter. Reduce allergen exposure, or treat allergies with appropriate medication if recommended by your doctor. Keep the inside of your nose moisturized by using nasal saline sprays or gels twice daily. Avoid picking your nose. Avoid smoke exposure. […] Most of the time, nosebleeds will stop on their own or will respond well to applying pressure as described above. However, there are some situations where seeking medical care is required, including: Bleeding does not stop after 30 minutes of applying direct pressure to the nose. You feel faint or lightheaded. You have other bleeding symptoms, including bruising. You are taking blood thinner medications. There is trauma or injury to the face along with the nosebleed. There is a foreign object in your nose. You experience nosebleeds often. If you experience any of these symptoms, please seek medical attention. Healthcare providers have the tools to help stop the bleeding and can be sure there are no other complications.

• #3 Nosebleed (Epistaxis) – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/nosebleed.html

  Anterior rhinoscopy should be performed to identify a source of bleeding after removal of any blood clot (if present) for individuals with nosebleeds. […] Nasal endoscopy should be performed to identify the site of bleeding and guide further management for individuals with recurrent nasal bleeding, despite prior treatment with packing or cautery, or with recurrent unilateral nasal bleeding. […] Individuals with an identified site of bleeding should be treated with an appropriate intervention, which may include one or more of the following: topical vasoconstrictors, nasal cautery, and moisturizing or lubricating agents. […] Individuals with persistent or recurrent bleeding not controlled by packing or nasal cauterization should be evaluated for candidacy for surgical arterial ligation or endovascular embolization.

• #3 Nosebleed Causes and Treatments – familydoctor.org

  https://familydoctor.org/condition/nosebleeds/

  Once the bleeding stops, wait a few hours before doing anything that might make it start again, such as bending over or blowing your nose. […] See your doctor if: The bleeding goes on for more than 20 minutes. The bleeding was caused by an injury, such as a fall or something hitting your face. In some cases, this may be a sign of internal bleeding. The amount of blood makes it hard to breathe. A child under 2 has a nosebleed. You’re taking a blood thinning medicine. You get nosebleeds weekly. […] Your doctor will try to find out where the bleeding is coming from in your nose. He or she will probably ask you some questions and examine your nose. If the bleeding doesn’t stop on its own or when pressure is applied, your doctor may cauterize the bleeding vessel or pack your nose to stop the bleeding. Cauterization involves using a special solution called silver nitrate or an electrical or heating device to burn the vessel so that it stops bleeding. Your doctor will numb your nose before the procedure. Packing the nose involves putting special gauze or an inflatable latex balloon into the nose so that enough pressure is placed on the vessel to make it stop bleeding.

• #3 How To Stop & Prevent Nosebleeds

  https://www.webmd.com/first-aid/nosebleeds-causes-and-treatments

  If your doctor cant get your nosebleed to stop with pressure, they might try: Cauterization. This procedure burns a blood vessel closed. After your doctor numbs your nose, theyll use either a heated electronic device (an electrocautery) or a chemical called silver nitrate to close the leaky blood vessel. […] Packing. Your doctor puts a latex balloon or gauze into your nostril. This puts a lot of pressure on a blood vessel until it closes.

• #3 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  Anterior packing – Synechia, rhinosinusitis, toxic shock syndrome, eustachian tube dysfunction, scarring of the nasal ala and columella […] Posterior packing – Synechia, rhinosinusitis, toxic shock syndrome, eustachian tube dysfunction, dysphagia, scarring of nasal ala and columella, hypoventilation, sudden death […] Transantral internal maxillary artery ligation – Anesthetic risks, rhinosinusitis, oroantral fistula, infraorbital numbness, dental injury […] Transoral internal maxillary artery ligation – Anesthetic risks, cheek numbness, trismus, tongue paresthesia […] Anterior or posterior ethmoidal artery ligation – Anesthetic risks, rhinosinusitis, lacrimal duct injury, telecanthus, blindness […] Embolization – Facial pain, trismus, facial paralysis, skin necrosis, blindness, stroke, groin hematoma.

• #3 Epistaxis Treatment & Management: Approach Considerations, Manual Hemostasis, Humidification and Moisturization

  https://emedicine.medscape.com/article/863220-treatment

  When medical attention is needed for epistaxis, it is usually because of the problem is either recurrent or severe. Treatment depends on the clinical picture, the experience of the treating physician, and the availability of ancillary services. […] In most patients with epistaxis, the bleeding responds to cauterization, nasal packing, or both. For those who have recurrent or severe bleeding for which medical therapy has failed, various surgical options are available. After surgery or embolization, patients should be closely observed for any complications or signs of rebleeding. […] Medical approaches to the treatment of epistaxis may include the following: Adequate pain control in patients with nasal packing, especially in those with posterior packing (However, the need of adequate pain control has to be balanced with the concern over hypoventilation in the patient with posterior pack.)

• #3 Epistaxis (Nosebleed) Management – CureHHT

  https://hhtguidelines.org/epistaxis/

  A1: The expert panel recommends that patients with HHT-related epistaxis use moisturizing topical therapies that humidify the nasal mucosa to reduce epistaxis. […] A2: The expert panel recommends that clinicians consider the use of oral tranexamic acid for the management of epistaxis that does not respond to moisturizing topical therapies. […] A3: The expert panel recommends that clinicians should consider ablative therapies for nasal telangiectasias including laser treatment, radiofrequency, electrosurgery, and sclerotherapy in patients that have failed to respond to moisturizing topical therapies. […] A4: The expert panel recommends that clinicians consider the use of systemic antiangiogenic agents for the management of epistaxis that has failed to respond to moisturizing topical therapies, ablative therapies and/or tranexamic acid.

• #3 Nosebleed Treatment in Denver, Lone Tree & Castle Rock, CO AOO | ENT Specialists of the Rockies

  https://www.denvercoloradoearnosethroatallergysinusdoctors.com/ent/nose/bleeds/

  When nosebleeds are less troublesome but continue to be a minor nuisance problem, hygiene and a humidification maintenance program may be necessary. Many physicians suggest any of the following lubricating creams or ointments, such as saline gel. Up to three applications a day may be needed, but usually, every night at bedtime is enough. A saline nasal spray will also moisten dry nasal membranes. […] If the nosebleeds persist, you should see your doctor. Using an endoscope, a tube with a light for seeing inside the nose, your physician may find a problem within the nose that can be fixed. He or she may recommend cauterization (sealing) of the blood vessel that is causing the trouble. […] To prevent rebleeding after initial bleeding has stopped: […] Do not pick or blow your nose. […] Do not strain or bend down to lift anything heavy.

• #3 Epistaxis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/863220-overview

  In most patients with epistaxis, the bleeding responds to cauterization, nasal packing, or both. […] Medical approaches to the treatment of epistaxis may include the following: Adequate pain control in patients with nasal packing, especially in those with posterior packing (However, the need of adequate pain control has to be balanced with the concern over hypoventilation in the patient with posterior pack.) […] Oral and topical antibiotics to prevent rhinosinusitis and possibly toxic shock syndrome […] Avoidance of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) […] Medications to control underlying medical problems (eg, hypertension, vitamin K deficiency) in consultation with other specialists. […] The choice of the specific vessel or vessels to be ligated depends on the location of the epistaxis.

• #3 Epistaxis – Nose Bleed Causes, Treatment & Prevention

  https://www.tegbirsidhu.com/epistaxis-nosebleed.php

  Where severe nosebleeds keep occurring, surgery may be an option, such as arterial ligation. In this procedure, a doctor will tie up the specific blood veins causing the nosebleeds, preventing them from bleeding. This may require local or general anaesthesia. […] For those patients, embolisation, a minimally invasive procedure that requires local anaesthesia only, may be an alternative. This involves making a small cut, inserting a catheter into a peripheral artery, and using image guidance to move it to the vessels that lead to the point of the bleeding. The specialist will then use one of several materials, such as liquid tissue glue, microcoils, beads or particles, to block the bleeding vessel.

• #3 Nosebleed (Epistaxis) in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/n/nosebleed-epistaxis-in-children.html

  How is a nosebleed treated in a child? […] Keep your child calm and comfort them. Tell your child to breathe normally out of their mouth. […] Have your child stand or sit up and lean their head forward to help stop them from swallowing the blood. This also prevents the blood from pooling in the throat. Keep a cloth or towel under their nose to absorb any blood. Don’t have your child lie down or tilt their head back. If your child appears to be swallowing blood or has a lot of blood in the mouth, have them spit the blood out. If blood is swallowed, it can lead to vomiting. […] Continue squeezing your child’s nose closed for 5 to 10 minutes. Don’t stop pinching to check if bleeding has stopped. […] If bleeding continues, repeat the step above by squeezing the nose for 5 to 10 minutes without looking to see if bleeding has stopped.

• #3 Laser Treatment for Nosebleeds: When Is It Likely to Work? – CureHHT

  https://curehht.org/research_project/laser-treatment-nosebleeds-likely-work/

  Over the years, a wide variety of treatments have been used to help manage nosebleeds in HHT patients including electro-cauterization, nasal packing, septodermoplasty (see article herein), arterial embolization, arterial ligation, and hormone therapy. […] recent attention has focused on the use of lasers for the treatment of intranasal telangiectases in patients with HHT. […] Patient responses to therapy were evaluated. Patients were identified as a responder to the Nd-YAG laser treatment if they noted a 50% decrease in the severity and frequency of their nosebleeds for a period of greater than 6 months. […] Interestingly, vascular pattern I was most common, while vascular pattern III was least common. Patients with vascular pattern I uniformly demonstrated a good response to the Nd-YAG laser.

• #4 How To Stop a Nosebleed

  https://health.clevelandclinic.org/how-to-stop-a-nosebleed

  Keep the pressure for at least 10 to 15 minutes before checking to see if the bleeding has stopped, Dr. Chaaban advises. Just set a timer and sit tight, even if you think you feel like the bleeding has stopped. […] If your nosebleed is still stubborn, a nasal spray may help stuff it up faster. You can spray an over-the-counter decongestant spray like oxymetazoline (Afrin, Dristan, Neo-Synephrine or Vicks Sinex) into the bleeding side of your nose and then apply pressure to your nose. […] A bloody nose can sometimes be a red flag your body is waving. In those cases, youll need more help than a box of tissues. If the bleeding is coming from more prominent blood vessels in the back of your nose, it may require further management, Dr. Chaaban points out. […] Persistent and recurring nosebleeds can be a sign of another health issue, says Dr. Chaaban. If you get frequent nosebleeds, nosebleeds that just wont stop or if your nosebleeds are accompanied by other symptoms, such as numbness or pressure in your face, make an appointment with an ear, nose and throat doctor to get it checked out.

• #4 How To Stop a Nosebleed

  https://health.clevelandclinic.org/how-to-stop-a-nosebleed

  If you want to avoid bloody noses in the future, try these tips: Keep your nose moist. Especially in the wintertime, make sure you either use nasal saline or a humidifier to keep your nasal passages moist. Most bleeding is related to dry air in the winter. […] Nosebleeds can stop you in your tracks. But by staying calm, being patient, sitting up straight and applying pressure, most bloody noses will come to pass. If youre experiencing frequent or severe nosebleeds, its always a good idea to consult a healthcare provider, as this may indicate an underlying problem.

• #4 Clinical Practice Guideline: Nosebleed (Epistaxis) – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31910111/

  The guideline development group made recommendations for the following key action statements: (1) At the time of initial contact, the clinician should distinguish the nosebleed patient who requires prompt management from the patient who does not. (2) The clinician should treat active bleeding for patients in need of prompt management with firm sustained compression to the lower third of the nose, with or without the assistance of the patient or caregiver, for 5 minutes or longer. (3a) For patients in whom bleeding precludes identification of a bleeding site despite nasal compression, the clinician should treat ongoing active bleeding with nasal packing. (3b) The clinician should use resorbable packing for patients with a suspected bleeding disorder or for patients who are using anticoagulation or antiplatelet medications. (4) The clinician should educate the patient who undergoes nasal packing about the type of packing placed, timing of and plan for removal of packing (if not resorbable), postprocedure care, and any signs or symptoms that would warrant prompt reassessment. (5) The clinician should document factors that increase the frequency or severity of bleeding for any patient with a nosebleed, including personal or family history of bleeding disorders, use of anticoagulant or antiplatelet medications, or intranasal drug use. (6) The clinician should perform anterior rhinoscopy to identify a source of bleeding after removal of any blood clot (if present) for patients with nosebleeds. (7a) The clinician should perform, or should refer to a clinician who can perform, nasal endoscopy to identify the site of bleeding and guide further management in patients with recurrent nasal bleeding, despite prior treatment with packing or cautery, or with recurrent unilateral nasal bleeding. (8) The clinician should treat patients with an identified site of bleeding with an appropriate intervention, which may include one or more of the following: topical vasoconstrictors, nasal cautery, and moisturizing or lubricating agents. (9) When nasal cautery is chosen for treatment, the clinician should anesthetize the bleeding site and restrict application of cautery only to the active or suspected site(s) of bleeding. (10) The clinician should evaluate, or refer to a clinician who can evaluate, candidacy for surgical arterial ligation or endovascular embolization for patients with persistent or recurrent bleeding not controlled by packing or nasal cauterization. (11) In the absence of life-threatening bleeding, the clinician should initiate first-line treatments prior to transfusion, reversal of anticoagulation, or withdrawal of anticoagulation/antiplatelet medications for patients using these medications. (12) The clinician should assess, or refer to a specialist who can assess, the presence of nasal telangiectasias and/or oral mucosal telangiectasias in patients who have a history of recurrent bilateral nosebleeds or a family history of recurrent nosebleeds to diagnose hereditary hemorrhagic telangiectasia syndrome. (13) The clinician should educate patients with nosebleeds and their caregivers about preventive measures for nosebleeds, home treatment for nosebleeds, and indications to seek additional medical care. (14) The clinician or designee should document the outcome of intervention within 30 days or document transition of care in patients who had a nosebleed treated with nonresorbable packing, surgery, or arterial ligation/embolization.

Zobacz więcej