This document discusses epistaxis (nosebleeds), including common causes, types, signs, diagnosis, and treatment. It notes that anterior nosebleeds are more common in children from minor trauma, while posterior bleeds often occur in older adults from hypertension. Evaluation includes vital signs, blood tests, and imaging. Treatment depends on severity but may involve local pressure, cauterization, nasal packing, or embolization for severe or recurrent bleeding. Nurses monitor patients and provide aftercare instructions to prevent rebleeding.

1. presented by: hemant Sharma
(Msc Nursing)
Associate Professor
Department of Medical Surgical
Nursing
Ranthambhore College of Nursing
swm Raj

3.  The common causes of :
 Major trauma
 Nose picking
 Foreign body stuck in the nose
 repeated sneezing
 large doses of aspirin
 Nasopharyngeal tumors
 Hot summer month
 upper respiratory infection

4.  Leukemia
 Bleeding disorder
 Clotting disorder
o Acute infections
 Thrombocytopenia

5. ANTERIOR EPISTAXIS
 More common .
 Mostly from Little’s area or
anterior part of lateral wall .
 Mostly occurs in children
or young adults .
 Mostly trauma .
 Usually mild, can be easily
controlled by local pressure
or anterior pack.
POSTERIOR EPISTAXIS
Less common .
 Mostly from posterior
superior part of nasal cavity .
 After 40 years of age
 Spontaneous; often due to
hypertension or
arteriosclerosis.
 Bleeding is severe,
requires hospitalization;
postnasal pack often required

6.  Recurrent Epistaxis:- in recurrent nose bleeds the episode
of bloods happens only at certain periods of time.
Recurrent nosebleed can be occur in seasonal . 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)
 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.

7.  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.

8. Signs of excessive blood loss include:
 Dizziness
 Weakness
 Confusion
 Fainting
COMPLICATION
 Hypotension
 Shock
 Anemia
 Secondary infection

9.  Blood pressure
 Complete blood count
 Coagulation studies
 Angiography
 MRI
 X ray

10.  Identification of bleeding sit by a nasal speculum
or headlight.
Little’s area- pinching the nose with thumb and
index finger for about 5 minutes- compression of
vessels.

12.  Silver nitrate application gel form.
 ELECTROCAUTERIZATION

13.  Posterior nasal packing with a vasoconstriction
solution.
 Cotton tampon .
 Suction to remove the blood clots .
 Radiologic embolization of the artery .
 Ligation of the internal maxillary artery.

14.  Monitor vital signs.
 Assisting in the control of bleeding .
 Provide tissue paper and cotton.
 To instructed child to avoid aspiration of blood.
 Nasal packing may alter respiration status so
closely monitor respiratory rate, heart rate, rhythm.


15.  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 wear loose garments.
 Instruct the child to avoid vigorous nasal blowing,
strenuous activity, or lifting straining for4-6 week.