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Nose bleeding
Written By: Dr Ibrahim Issa MD. Otolaryngology Consultant , Laryngologist & Phonosurgeon.
Edited By: Dr Mohammad Murad MD. Otolaryngology Specialist.
Nose bleeding is one of the common emergency room complaints. The picture of having blood coming out of your nose or your sons nose is terrifying for most people, and despite it’s simple cause in most of the cases, it brings fear to the patient, The family and the medical staff as well.
The goal of this article is to give a glance about the common causes of nose bleeding and the simple ways to deal with bleeding nose, and to differentiate between the right and wrong ways of dealing with a bleeding nose.
Nose bleeding might come as severe bleeding or recurrent minimal bleeding, both of these scenarios can be due to similar causes, for that reason, both cases should be examined and the cause of bleeding should be determined.
The most common cause of bleeding is dryness of the blood vessels of the nasal septum, that causes cracking of the vessels and bleeding, other causes might include trauma with injury to the nasal mucosa, tumors of the nose or the sinuses, sever chronic inflammation that can damage some vessels, and surgical procedures done in the nose and sinuses.
Treatment of active nasal bleeding starts always with nose compression, compression on the soft cartilaginous part of the nose by pitching the nose between the thumb and index fingers is the best way of compression (as the picture shows), keeping the head in any position, though normal head position for a standing person is fine. Compression on the bony 
upper part of the nose is not helpful at all, putting the head backward is also not helpful.
The compression should be continuous for around five to 15 minutes, intermittent compression may not help, and putting some ice or cold compressors on the forehead might be helpful.
Nose compression could be done by the patient himself, by his companion, or by the doctor, but if the bleeding didn’t stop, a doctor consultation is then required and other ways of stopping the bleeding could be done including packing of the nose, cauterization or surgery.
Some people try to put cotton or tissue pieces in the nose to stop the bleeding, I think it’s better not to do that, because dry cotton or tissue put under no vision of the inner part of the nose by non experienced person might cause further damage to the already dry and cracked vessel, while this can be done if needed by the doctor under light visualization of the nasal cavity.
For cases of recurrent bleeding, where the cause is known, it should be treated accordingly, while dryness is one of the most cases, lubrication by special ointments is enough, even though, cauterization of the bleeding dry group of vessels might be needed if lubrication was not sufficient.
Last thing to say, is that nose bleeding might be due to other systems problem, other medical illnesses, or the use of some medications, for that reason, a detailed history should be given to the treating doctor and sometimes investigations are needed
Written By: Dr Ibrahim Issa MD. Otolaryngology Consultant , Laryngologist & Phonosurgeon.
Edited By: Dr Mohammad Murad MD. Otolaryngology Specialist.
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