The association between hypertension and epistaxis is probably a myth. Although hypertension is common when patients present with acute bleeding the incidence of undiagnosed hypertension found on follow up is no higher than would be expected in the general population.

Management

  • Initial assessment - First Aid

    • Maintain a calm attitude around the patient - but protect yourself (gloves, gown and goggles - the 3Gs).

    • Resuscitate the patient (if necessary) - remember the ABCD(E) of resuscitation.

    • Take a quick history:

      • Which nostril is bleeding? Is there blood the pharynx?

      • How much blood loss has there been? Are there symptoms of hypovolaemia?

      • Is the bleeding recurrent? What measures have been tried before?

      • Past medical history (e.g. recent trauma) and current medication (especially aspirin or warfarin).

    • Get the patient to sit upright, leaning slightly forward; and to squeeze the bottom part of the nose (NOT the bridge of the nose) for 10-20 minutes to try and stop the bleeding . Patient should breathe through the mouth and spit out any blood/saliva into a bowl. An ice pack on the bridge of the nose may help.

Return to top

 

appointment appointment

next previous