epitaxis- its types, causes, sign and symptoms, diagnostic evaluation, surgical management and nursing management and its complication.it consist of images that will help in easy understanding of the topic. language is also easy to understand.

2.  Epistaxis is common in children. In infant
almost 30% of children have this problem.
From 0 to 5 year old have epistaxis is 56%,
from 6 to 10 yr old children have 64%.

3.  When one or two small veins in the nose
erupt the resulting condition is nose bleed or
epistaxis
Bleeding occur usually from anterior-
inferior portion of the cartilaginous nasal
septum due to run capillary vasculature in
this zone known as little area or
kiesselbach’s plexus.

5.  Recurrent Epistaxis:- in recurrent nose
bleeds, the episode of bloods happens only
at certain periods of time. Recurrent
nosebleed can be occur in seasonal
pattern. Its most happen when the
weather get hot and dry.
 Constant Epistaxis:- this is type of
nosebleed that happens for a longer
period of time. The bleeding is
continuously occur.( 45min)

6.  Sudden epistaxis:- These are nosebleeds
which could happen anytime of the day,
regardless of the activity of the child.
Whether the child resting or playing.
 Chronic epistaxis:- condition that are
continuously experienced for more then
6month. Chronic bleeding happen as result of
a chronic disease this include, Chronic liver
or kidney disease, vascular malformation,
long term use medication.

7.  Heavy nosebleed:- heavy nosebleeds pertain
to episodes where there is a significant
amount of blood coming out of the nose.
Only this type is seen immediate first aid
treatment must be employed.

8.  The common causes in children are:-
 Major trauma
 Nose pricking
 Foreign body in the nose
 Nasal injury
 Nasal polyp
 Rhinitis
 Nasal diphtheria
 Nasopharyngeal tumors
 Nasal spray abuse
 Hot summer month

9. Other systemic causes:-
 Leukemia
 Hemophilia
 Ingestion of aspirin
 Vitamin K deficiency
 Ca deficiency
 Nephritis
 Solar radiation
 Acute infections
 Thrombocytopenia

10.  Bleeding usually starts from one nostrils. In
case of heavy bleeding, it may fill up both
the nostrils and overflow the nasopharynx. In
certain cases, blood may drip back from the
nose through the throat to stomach.

11.  Hypotension
 Shock
 Anemia
 Secondary infection

12.  Complete blood count
 Coagulation studies
 Angiography
 Endoscopy
 MRI
 X ray

13.  First aid measures:-
 Keep the patient quiet
 Place the patient in a sitting position,
leaning forward, semifowler position.
 Apply direct pressure by pinching the entire
soft lower portion of the nose for 10 to
15min.
 Apply icepack to the nose and check area.
 Loosing clothes and giving reassurance.
 Partially insert a small gauze pad into the
nose.

14.  Bleeding nostril and apply digital pressure if
bleeding continues.
 Take medical treatment if bleeding dose not
stop.

15.  Identification of bleeding site by a nasal
speculum or headlight.
 Application of a vasoconstrictive agent.
 Cauterization
 Nasal packing

16. Anterior nasal bleeding:-
 Silver nitrate application gelform
 Electrocauterization
 Topical vasoconstrictor
adrenaline(1:100)
creaine(0.5%)
phenylephrine
Posterior nasal bleeding:-
Posterior nasal packing impregnate with a vaso
constricting solution.

17.  Cotton tempon
 Suction to remove the blood clots
 Radiologic embolization of the artery
 Ligation of the internal maxillary artery.

21.  Monitor vital signs.
 Assisting in the control of bleeding .
 Provide tissue paper and cotton.
 To instruct child to avoid aspiration of blood.
 Nasal packing may alter respiration status so
closely monitor respiratory rate, heart rate,
rhythm, LOC
 Instruct the child to avoid vigarous nasal
blowing, strenous activity, or lifting straining
for4-6 weak.

22.  Also instructed to avoid nasal blowing or
picking nose after nosebleed,
 Instructions to be given to the parents to
apply lubricant to nasal septum twice daily
to reduce dryness.
 Advice to were loose garments