Epistaxis, or nosebleeds, are common and usually not serious. They are often caused by dry air irritating the nasal membranes. Nosebleeds can also be triggered by colds, allergies, high blood pressure, medications, and injuries. Treatment involves sitting upright, pinching the nose to apply pressure, and seeking medical care if bleeding does not stop. If bleeding is severe or persistent, a healthcare provider may insert nasal packing to stop the bleeding. Nursing care focuses on monitoring for complications and providing comfort measures.

1. Epistaxis
• Bleeding from the nose, is a common
complaint.
• Rarely life threatening .but significant concern,
especially among parents of small children.
• Most benign, self-limiting, and spontaneous,
but some can be recurrent.
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2. Common causes
• Dry, heated, indoor air, which dries out the nasal
membranes and become cracked or crusted and
bleed
• Dry, hot, low-humidity climates, which can dry
out the mucus membranes
• Colds and sinusitis, cause repeated sneezing,
coughing, and nose blowing
• Vigorous nose blowing or nose picking
• The insertion of a foreign object into the nose
• Injury to the nose and/or face
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3. • Allergic and non-allergic rhinitis (inflammation of the
nasal lining)
• Use of drugs that thin the blood (aspirin, non-steroidal
anti-inflammatory medications, warfarin, and others)
• High blood pressure
• Chemical irritants (e.g., cocaine, industrial chemicals,
others)
• Deviated septum (an abnormal shape of the structure
that separates the two sides of the nose)
• Tumors or inherited bleeding disorders (rare)
• Facial and nasal surgery
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5. Medical mx
• Relax
• Sit down and lean body and head slightly
forward. This keep the blood from running
down throat, which can cause nausea,
vomiting, and diarrhea.
• Breathe through mouth.
• Use a tissue or washcloth to catch the blood.
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6. cont
• Use thumb and index finger to pinch anterior
portion of the nose .( apply pressure)It can help
stop bleeding. This area known kiesselbach’s
plexus
• Keep pinching nose continuously for at least 5-10
minutes . If still bleeding, continue for another
10 minutes.
• Apply of ice compresses . It can stopped bleeding
• Can apply of silver nitrate or nasal packing
• Once the bleeding stops, DO NOT blow, rub, or
pick your nose for several days.
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7. • If not stop the bleeding, nasal packing may be
inserted.it should remain 48-72 hrs.
• If posterior portion tends to cause swallowing
of blood.( more common in older)-a posterior
plug may required.
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8. Nasal packing
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9. Nursing management
• Monitor for hypoxia if using nasal packing
• Monitor blood pressure.
• Application of water soluble ointment around
the nares to provide lubrication, help alleviate
the discomfort.
• For surgical client observed for addition
bleeding
• Advice open discharge to minimize activity for
10 days.
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