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A nosebleed, also known as epistaxis, is an instance of bleeding from the nose. [1] Blood can flow down into the stomach, and cause nausea and vomiting. [8] In more severe cases, blood may come out of both nostrils. [9] Rarely, bleeding may be so significant that low blood pressure occurs. [1]
In severe cases or cases resistant to local treatment, functional endoscopic sinus surgery is indicated in order to re-establish drainage and ventilation of the sinuses. This treatment has shown good results in aviators who have recurrent sinus barotrauma.
A 48-year-old businessman was admitted with a severe nosebleed and abnormal coagulation parameters. Standard treatment of vitamin K and fresh plasma was administered to stem the nosebleed. Two weeks later, he presented again with bleeding into the calf. Continual doses of vitamin K were necessary to counteract the brodifacoum.
Tranexamic acid is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation. [ 6 ] [ 7 ] It is also used for hereditary angioedema .
Generally, treatment is with triazoles, preferably itraconazole. [5] A second choice is potassium iodide, either alone or combined with itraconazole. [5] In severe widespread disease, amphotericin B may be an option. [5] The condition has a good response to antifungal treatment, [7] but can recur. [8] The infection is rarely fatal but often ...
Epistaxis, or nosebleed, is a special case, where almost all first aid providers train the use of pressure points. The appropriate point here is on the soft fleshy part of the nose, which should constrict the capillaries sufficiently to stop bleeding, although obviously it does not stop bleeding from the nasopharynx or tear ducts .
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