Epistaxis - (a.k.a. Nosebleeds, Bloody Nose)

Epistaxis, more commonly referred to as a nosebleed or bloody nose, can be frightening for the person who experiences it and can cause much anxiety. It is estimated that 1 in 7 people will experience a bloody nose at some point.

Epistaxis is defined as an acute hemorrhage that can originate from one of three places, the nostril, the nasal cavity, or the nasopharynx. It is further classified on the basis of the main site of bleeding. Anterior hemorrhage is the most common site of epistaxis, usually originating from the nasal septum. Posterior bleeds are less common, but may be more severe and are more likely to require professional care.

Epistaxis has a peak incidence in childhood, between the ages of 2 and 10, and in adulthood between the ages of 50 and 80 years. Mortality from a bloody nose is rare. When mortality occurs, it is usually due to severe hypovolemia (volume loss) and may be complicated by an underlying condition. Increased morbidity has been attributed to the use of nasal packing which can lead to respiratory depression and airway compromise. Nasal packing may also
have infection as a complication.

Symptoms

Nosebleeds typically involve one nostril, but occasionally both nostrils are involved. The
amount of blood loss can vary, with posterior nosebleeds typically causing more bleeding.
In a posterior nosebleed, blood can flow down the throat and into the stomach, which may
cause nausea and vomiting. In severe epistaxis, blood may travel up the nasolacrimal duct
and out through the eye.

Causes

There are numerous causes and conditions that are associated with the development of
nosebleeds. In some cases, there may be no readily identifiable cause of epistaxis:

• Local trauma- Local trauma is the most frequent cause of nosebleeds. Local trauma
  may occur from insertion of objects in to the nose, most commonly fingers.
  Insertion of foreign bodies into the nose is also a common cause, especially in
  children.
• Facial trauma-Falls and accidents causing trauma to the face, especially associated
  with broken bones, can cause significant bleeding.
• Nasal/Sinus infections- Infection can cause vessels in the nose to bleed. Sinus
  infections may cause frequent bouts of sneezing and frequent blowing of the nose,
  both of which may cause bleeding by increasing the pressure in these vessels.
  Common colds and allergic rhinitis are also associated with epistaxis.
• Oral anticoagulants- Medications like Warfarin (Coumadin), used to prevent blood
  clots from forming, are a frequent cause of nosebleeds.
• Coagulopathy- Several conditions are known to predispose to epistaxis, such as
  sphlenomegaly, thrombocytopenia, platelet disorders, and other bleeding disorders,
  such as Von Willebrand’s disease and hemophilia. These conditions may affect the
  body’s ability to form blood clots necessary to stop bleeding when it occurs.
• Hypertension- Nosebleeds are more common in people who have high blood
  pressure, although hypertension is not thought to be a direct cause of epistaxis.
• Vascular abnormalities- There are several conditions that affect blood vessels that
  may predispose to nose bleeds. Some of these conditions include having sclerotic
  vessels, hereditary telangiectasia, and AV malformation (arteriovenous malformation).
• Neoplasm- Cancerous tumors of the nasal cavity may cause bleeding to occur if the
  tumor erodes into blood vessels.
• Septal perforation/Deviation- Abnormalities of the septum cause uneven air flow between the nostrils, causing one nostril to receive more air, which may lead to dryness and cracking of nasal tissues.
• Endometriosis- Although uncommon, endometriosis can cause nosebleeds if endometrial patches seed in the nasal passages.
• Dry/Heated Air- Having a bloody nose is much more common in the winter due to low humidity and dry air. Dry, hot, low-humidity climates cause the same problem, which is the drying out of nasal tissue, which in turn causes the tissue to crack or crust. Rubbing, picking, or blowing the nose causes this delicate tissue to bleed.
• Chemical Irritants- The use of cocaine or inhaling chemical irritants can cause a bloody nose.
• Heavy Alcohol Use- Using alcohol regularly can cause blood dyscrasisas that may cause bleeding.
• Homeopathic Medications- There are several homeopathic remedies and dietary supplements that that are associated with higher risk of bleeding. Some of these include feverfew, ginger, don quai, vitamin E, gingko biloba, garlic, danshen, and ginseng. Many people take these supplements and are not aware that they can contribute to a bloody nose.
• Pregnancy- The condition of pregnancy causes blood vessels to expand. Additionally, pregnancy causes a higher blood volume, which can increase pressure on already dilated blood vessels.

Prevention

Prevention of nosebleeds is not always possible, but incorporating some of these simple measures may decrease the risk of epistaxis:

• Saline drops or spray- Instilled into the nose 2-3 times a day, nasal drops and saline sprays can help to keep nasal passages moist and free of cracks and sores.
• Water-Soluble Gels/Ointments- Examples include petrolatum jelly, polysporin, and Vaseline, which can be applied to the nasal tissues to keep tissues moist.
• Avoidance Measures Avoiding vigorous blowing of the nose and sneezing with a wide-open mouth will prevent excess pressure on the nasal blood vessels. Avoid putting any objects, including a finger, in the nose.
• Medications-Avoid over-use of medications that can cause bleeding, such as aspirin and ibuprofen. Be aware that certain homeopathic medications may also increase tendency to bleed. Do not adjust medications, such as Coumadin, without physician approval.
• See a specialist- If allergy symptoms are not well controlled, seeing an allergist may be necessary. Other conditions that predispose to bleeding may require specialist consultation if epistaxis is frequent.
• Quit Smoking- Smoking irritates and dries nasal passages.
• Use protective equipment Use appropriate protective gear to prevent the inhalation of chemicals or irritating substances.

NoseBudd

NoseBudd is a gel pack specially designed to stop nose bleeds rapidly by combining cold therapy with
moderate pinching pressure, two methods shown to be highly effective in stopping nose bleeds.

NoseBudd works more quickly than other conventional methods and is designed to be reusable, and
thus is a highly cost-effective method of treating epistaxis.

The unique design of NoseBudd allows for NoseBudd to provide cold therapy to the area where it is
needed, avoiding causing numbness and cold to the face.

NoseBudd is generally effective at stopping a bloody nose in 5 minutes, much more quickly than
traditional methods.

Seeking Professional Care

Although NoseBudd is highly effective at stopping nosebleeds, there are times when, due to the severity or location of the nosebleed, professional treatment should be sought. Go to the emergency room when:

• The bleeding does not stop after 15-20 minutes of continues use of NoseBudd
• You experience numerous episodes of bleeding
• Your blood loss exceeds a coffee cupful and bleeding is very rapid
• Your bleeding is due to trauma to the face
• You feel very faint or weak
• Blood is running down the back of your throat even when you are sitting and leaning slightly forward

NoseBudd is an effective and cost-efficient method of stopping a nosebleed, used by schools, athletic departments, camps, and individuals. If you are interested in learning more about NoseBudd, or would like to order NoseBudd, please visit our web site at www.nosebudd.com.