EPISTAXIS(BLEEDING THROUGH NOSE)
Epistaxis is the relatively common occurrence of bleeding from the nose, usually noticed when the blood drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, more likely to require medical attention).
Sometimes in more severe cases, the blood can come up the naso-lacrimal duct and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause nausea and vomiting It is rarely fatal.The causes of nosebleeds can generally be divided into two categories, local and systemic factors, although a significant number of nosebleeds occur with no obvious cause.
Among local factors,trauma,foreign body or local infections are responsible for bleeding through nose.Anatomical deformities like septal spur,drugs like cocaine,nasal tumours,low humid conditions(cold winter),ear baro trauma due to descent of aircraft,ascent in scuba diving)etc
Systemic causes include hypertension,bleeding disorders,patients on anti-coagulants,aspirin etc.
Nosebleeds are due to the rupture of a blood vessel within the richly perfused nasal mucosa.An increase in blood pressure (e.g. due to general hypertension) tends to increase the duration of spontaneous epistaxis.Anti-coagulant medication and disorders of blood clotting can promote and prolong bleeding. Spontaneous epistaxis is more common in the elderly as the nasal mucosa (lining) becomes dry and thin and blood pressure tends to be higher. The elderly are also more prone to prolonged nose bleeds as their blood vessels are less able to constrict and control the bleeding.
Epistaxis is the relatively common occurrence of bleeding from the nose, usually noticed when the blood drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, more likely to require medical attention).
Sometimes in more severe cases, the blood can come up the naso-lacrimal duct and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause nausea and vomiting It is rarely fatal.The causes of nosebleeds can generally be divided into two categories, local and systemic factors, although a significant number of nosebleeds occur with no obvious cause.
Among local factors,trauma,foreign body or local infections are responsible for bleeding through nose.Anatomical deformities like septal spur,drugs like cocaine,nasal tumours,low humid conditions(cold winter),ear baro trauma due to descent of aircraft,ascent in scuba diving)etc
Systemic causes include hypertension,bleeding disorders,patients on anti-coagulants,aspirin etc.
Nosebleeds are due to the rupture of a blood vessel within the richly perfused nasal mucosa.An increase in blood pressure (e.g. due to general hypertension) tends to increase the duration of spontaneous epistaxis.Anti-coagulant medication and disorders of blood clotting can promote and prolong bleeding. Spontaneous epistaxis is more common in the elderly as the nasal mucosa (lining) becomes dry and thin and blood pressure tends to be higher. The elderly are also more prone to prolonged nose bleeds as their blood vessels are less able to constrict and control the bleeding.
The vast majority of nose bleeds occur in the anterior (front) part of the nose from the nasal septum. This area is richly endowed with blood vessels. This region is also known as Littles area. Bleeding farther back in the nose is known as a posterior bleed and is usually due to bleeding from Woodruff's plexus, a venous plexus situated in the posterior part of inferior meatus. Posterior bleeds are often prolonged and difficult to control. They can be associated with bleeding from both nostrils and with a greater flow of blood into the mouth.
The flow of blood normally stops when the blood clots, which may be encouraged by direct pressure applied by pinching the soft fleshy part of the nose.Pressure should be firm and be applied for at least five minutes and up to 20 minutes; tilting the head forward will help decrease the chance of nausea and airway obstruction. Swallowing excess blood can irritate the stomach and cause vomiting.
The local application of a vasoconstrictive agent has been shown to reduce the bleeding time in benign cases of epistaxis. The drugs oxymetazoline or phenylephrine are widely available in over-the-counter nasal sprays.If these simple measures do not work then medical intervention may be needed to stop bleeding. In the first instance this can take the form of chemical cautery of any bleeding vessels or packing of the nose with ribbon gauze or an absorbent dressing (called anterior nasal packing)This is a painful procedure and the nasal mucosa should be anaesthetised first, and performed by experts.
Ongoing bleeding despite good nasal packing is a surgical emergency and can be treated by endoscopic evaluation of the nasal cavity under general anaesthesia to identify an elusive bleeding point or to directly ligate (tie off) the blood vessels supplying the nose.Application of a topical antibiotic ointment to the nasal mucosa has been shown to be an effective treatment for recurrent epistaxis.
There is Japanese folk belief according to which nosebleeds are signs of sexual excitement. (Interestingly, the nose is now known to contain erectile tissue which may become engorged during sexual arousal:honeymoon rhinitis is a condition in which nasal stuffiness or sneezing accompanies sexual thoughts or activities).There is increased incidence of epistaxis in high altitude due to low atmospheric pressure.
more in blog:
HYPOGLYCEMIA
ACUTE PAIN ABDOMEN
HAEMETEMESIS
THROMBOSED,PAINFUL PILES
ACUTE TUBULAR NECROSIS
PARAPHIMOSIS
TESTICULAR TORSION
TRAUMA
RENAL COLIC
PRIAPISM
ACUTE URINE RETENSION
SEVERE PALLOR
ABSCESS
ANIMAL BITES
POISONING
BURNS
SEIZURES
PARALYTIC STROKE
ANY PREGNANCY RELATED EVENT
SUDDEN LOSS OR IMPAIRMENT OF VISION
SUDDEN HEAD ACHE AND VOMITING
HIGH GRADE FEVER
NON-RESPONSIVENESS
VIOLENT BEHAVIOUR
SUDDEN CALF PAIN
SEVERE BREATHLESSNESS
Thanks for sharing the report on bleeding through nose . Most of the time this is very general .But some time it may be the bid problem .At that time people have need to consult with the doctor .
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