digplanet beta 1: Athena
Share digplanet:

Agriculture

Applied sciences

Arts

Belief

Business

Chronology

Culture

Education

Environment

Geography

Health

History

Humanities

Language

Law

Life

Mathematics

Nature

People

Politics

Science

Society

Technology

For the plant, see Yarrow.
Nosebleed
Classification and external resources
BrokenNose.jpg
ICD-10 R04.0
ICD-9 784.7
DiseasesDB 18327
MedlinePlus 003106
eMedicine emerg/806 ent/701, ped/1618
Patient UK Nosebleed
MeSH C08.460.261

Epistaxis (from Greek: ἐπιστάζω epistazo, "to bleed from the nose" from ἐπί epi, "above, over" and στάζω stazo, "to drip [from the nostrils]") or a nosebleed is the relatively common occurrence of hemorrhage 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 nasolacrimal duct and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause nausea and vomiting.[citation needed] Although the sight of large amounts of blood can be alarming to some, and, in some serious cases, may warrant medical attention, nosebleeds are rarely fatal, accounting for only 4 of the 2.4 million deaths in the U.S. in 1999.[1]

Cause[edit]

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.

Local factors[edit]

Other possible factors[edit]

Systemic factors[edit]

Most common factors[edit]

Other possible factors[edit]

Pathophysiology[edit]

Nosebleeds are due to the rupture of a blood vessel within the richly perfused nasal mucosa. Rupture may be spontaneous or initiated by trauma. Nosebleeds are reported in up to 60% of the population with peak incidences in those under the age of ten and over the age of 50 and appear to occur in males more than females.[3] An increase in blood pressure (e.g. due to general hypertension) tends to increase the duration of spontaneous epistaxis.[4] Anticoagulant 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 (Kiesselbach's plexus). This region is also known as Little's 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.[5] 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.[3]

Treatment[edit]

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. This applies pressure to Little's area (Kiesselbach's area), the source of the majority of nose bleeds, and promotes clotting. Pressure should be firm and be applied for at least five minutes and up to 20 minutes; tilting the head forward helps decrease the chance of nausea and airway obstruction.[3] Swallowing excess blood can irritate the stomach and cause vomiting.

Medications[edit]

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 for the treatment of allergic rhinitis, and they may be used for this purpose.[6]

Procedures[edit]

If these simple measures do not work then medical intervention may be needed to stop bleeding. The use of silver nitrate to cauterize bleeding blood vessels is common but not very useful for those with more than mild bleeding.[7] It is also often painful even when freezing is used.[8]

There are two types of nasal packing, anterior nasal packing and posterior nasal packing.[9] There are a number of different types of anterior nasal packs. Some use gauze and others use balloons.[9] Posterior packing can be achieved by using a Foley catheter, blowing up the balloon when it is in the back of the throat, and applying traction.[9] Ribbon gauze or Merocel packing can also be used.[9]

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. These blood vessels include the sphenopalatine, anterior and posterior ethmoidal arteries. More rarely the maxillary or a branch of the external carotid artery can be ligated. The bleeding can also be stopped by intra-arterial embolization using a catheter placed in the groin and threaded up the aorta to the bleeding vessel by an interventional radiologist.[10] There is no difference in outcomes between embolization and ligation as treatment options, but embolization is considerably more expensive.[11] Continued bleeding may be an indication of more serious underlying conditions.[10]

Other[edit]

The utility of local cooling of the head and neck is controversial.[12] Some state that applying ice to the nose or forehead is not useful.[13][14] Others feel that it may promote vasoconstriction of the nasal blood vessels and thus be useful.[15]

Prevention[edit]

Application of a topical antibiotic ointment to the nasal mucosa has been shown to be an effective treatment for recurrent epistaxis.[16] One study found it as effective as nasal cautery in the prevention of recurrent epistaxis in patients without active bleeding at the time of treatment - both had a success rate of approximately 50 percent.[17]

Society and culture[edit]

In the visual language of Japanese comics (manga) and animation (anime), a sudden, violent nosebleed indicates that the bleeding person is sexually aroused.[18][19] This is based on a Japanese folk belief according to which nosebleeds are signs of sexual excitement.[20] (The nose contains erectile tissue that can become engorged during sexual arousal, and honeymoon rhinitis is a condition in which nasal stuffiness or sneezing accompanies sexual thoughts or activities.[21])

In American and Canadian usage, "nosebleed section" or "nosebleed seats" are common slang for seating at sporting or other spectator events that are the highest up and farthest away from the event. The reference alludes to the propensity for nasal hemorrhage at high altitudes, usually owing to lower barometric pressure.

In Finnish language, "begging for a nosebleed" is commonly used in abstract meaning to describe self-destructive behaviour, for example ignoring safety procedures or deliberately aggravating stronger parties.[22]

In Filipino slang, to "have a nosebleed" is to have serious difficulty conversing in English with a fluent or native English speaker. It can also refer to anxiety brought on by a stressful event such as an examination or a job interview.[23]

In the Dutch language, "pretending to have a nosebleed" is a saying that means pretending not to know anything about something, when actually being involved somehow.

References[edit]

  1. ^ Work Table I. Deaths from each cause by 5-year age groups, race and sex: US, 1999 Page 1922. U.S. Centers for Disease Control Published 2001-05-11.
  2. ^ "What's in your protein drink". Retrieved 29 January 2012. 
  3. ^ a b c Corry J. Kucik & Timothy Clenney (January 15, 2005). "Management of Epistaxis". American Academy of Family Physicians. Retrieved January 31, 2010. 
  4. ^ J. F. Lubianca Neto, F. D. Fuchs, S. R. Facco, M. Gus, L. Fasolo, R. Mafessoni & A. L. Gleissner (1999). "Is epistaxis evidence of end-organ damage in patients with hypertension?". Laryngoscope 109 (7): 1111–1115. doi:10.1097/00005537-199907000-00019. PMID 10401851. 
  5. ^ The Journal of Laryngology & Otology (2008), 122: 1074-1077
  6. ^ Guarisco JL, Graham HD (1989). "Epistaxis in children: causes, diagnosis, and treatment". Ear Nose Throat J 68 (7): 522, 528–30, 532 passim. PMID 2676467. 
  7. ^ Stucker, F.J. (2009). Rhinology and facial plastic surgery. Berlin: Springer. p. 145. ISBN 9783540743804. 
  8. ^ Qureishi, A; Burton, MJ (Sep 12, 2012). "Interventions for recurrent idiopathic epistaxis (nosebleeds) in children.". The Cochrane database of systematic reviews 9: CD004461. doi:10.1002/14651858.CD004461.pub3. PMID 22972071. 
  9. ^ a b c d Killick, N; Malik, V; Nirmal Kumar, B (Mar 2014). "Nasal packing for epistaxis: an evidence-based review.". British journal of hospital medicine (London, England : 2005) 75 (3): 143–7. doi:10.12968/hmed.2014.75.3.143. PMID 24621629. 
  10. ^ a b MedlinePlus Medical Encyclopedia: Nosebleed U.S. National Library of Medicine Medline Plus service. Retrieved 2010-03-15.
  11. ^ Villwock, JA; Jones, K (Dec 2013). "Recent trends in epistaxis management in the United States: 2008-2010.". JAMA otolaryngology-- head & neck surgery 139 (12): 1279–84. doi:10.1001/jamaoto.2013.5220. PMID 24136624. 
  12. ^ Folz, BJ; Kanne, M; Werner, JA (November 2008). "[Current aspects in epistaxis].". HNO 56 (11): 1157–65; quiz 1166. doi:10.1007/s00106-008-1838-3. PMID 18936903. 
  13. ^ al.], edited by Roger Jones ... [et (2004). Oxford textbook of primary medical care. (repr. ed.). Oxford: Oxford University Press. p. 711. ISBN 9780198567820. 
  14. ^ Bissonnette, Bruno (2010). Pediatric Anesthesia. New York: McGraw-Hill Medical. p. 1182. ISBN 9781607950936. 
  15. ^ al.], A.Y. Elzouki ... [et. Textbook of clinical pediatrics (2nd ed. ed.). Berlin: Springer. p. 3968. ISBN 9783642022012. 
  16. ^ Kubba H, MacAndie C, Botma M, Robison J, O'Donnell M, Robertson G, Geddes N (2001). "A prospective, single-blind, randomized controlled trial of antiseptic cream for recurrent epistaxis in childhood". Clin Otolaryngol Allied Sci 26 (6): 465–8. doi:10.1046/j.1365-2273.2001.00502.x. PMID 11843924. 
  17. ^ Murthy P, Nilssen EL, Rao S, McClymont LG (1999). "A randomised clinical trial of antiseptic nasal carrier cream and silver nitrate cautery in the treatment of recurrent anterior epistaxis". Clin Otolaryngol Allied Sci 24 (3): 228–31. doi:10.1046/j.1365-2273.1999.00236.x. PMID 10384851. 
  18. ^ "Manga: The Complete Guide, reviewed by Richard von Busack". Metroactive. Retrieved 5 August 2011. 
  19. ^ Morgan, Joyce (February 10, 2007). "Superheroes for a complex world". The Sydney Morning Herald. Retrieved 5 August 2011. 
  20. ^ "Anime Physics: Nosebleeds". Anime News Network. 17 July 2010. Retrieved 5 August 2011. 
  21. ^ Sneezing 'can be sign of arousal'
  22. ^ http://saaressa.blogspot.fr/2011/01/finnsh-idioms.html
  23. ^ OMG! Nosebleed! Say what?! Retrieved 28 August 2013

External links[edit]


Original courtesy of Wikipedia: http://en.wikipedia.org/wiki/Nosebleed — Please support Wikipedia.
This page uses Creative Commons Licensed content from Wikipedia. A portion of the proceeds from advertising on Digplanet goes to supporting Wikipedia.
378626 videos foundNext > 

Vinnie Paz "Nosebleed" Feat. R.A. the Rugged Man and Amalie Bruun - Official Video

"Nosebleed" is from Vinnie Paz's debut solo album, "Season of the Assassin" available online at www.merchdirect.com/jedimindtricks. Directed by Ethan Blum Pr...

Blood Clot - Bizarre ER

Roger has been bleeding out of his beak for a week. Endless amounts of blood has been seeping from his nose and him and his wife are finally in to get it che...

Hilltop Hoods - The Nosebleed Section

Hilltop Hoods - Nosebleed Section Awesome riding skills by Simon O Brian. Enjoy!

Nose Bleed, On Location : BFX

This week we unveil a brand new type of BFX episode called "BFX On Location"! We've been invite by directors Giancarlo Fiorentini and Jonathan Grimm to creat...

Nose Bleed in the ER

This video demonstrates the management of a nose bleed in a 12 year old male with Merocel nasal packing.

How to Treat a Nosebleed | First Aid Training

Watch more How to Give First Aid videos: http://www.howcast.com/videos/504454-How-to-Treat-Poisoning-First-Aid-Training Learn how to treat a nosebleed in thi...

Nosebleeds - by Dr. Darren Saks

Dr. Darren Saks from Tenafly Pediatrics discusses causes of nosebleeds, how to treat them, and when you should be concerned that something more serious is go...

Beavis and Butt-Head Nosebleed Full Episode

More on http://www.beavisandbuttheads.com.

Children's First Aid: Nose Bleed

To treat a child with a nosebleed: Get the child to pinch the soft part of their nose Ask them to lean forward Continue to pinch the nose for ten minutes Cal...

Hilltop Hoods - The Nosebleed Section

a song i found and wanted to make a slide show vid of it and dont for get to subscribe.

378626 videos foundNext > 

2835 news items

CBS Local

CBS Local
Fri, 24 Oct 2014 11:12:16 -0700

COLUMBIA, S.C. (CBS Charlotte) — A plane was grounded at Columbia Metropolitan Airport earlier this morning due to an Ebola scare after a passenger reported a nosebleed. Earlier, Columbia Metropolitan Airport spokeswoman Kaela Harmon told The ...

Fox News

Fox News
Thu, 23 Oct 2014 01:30:03 -0700

The president of Cyprus was admitted to a hospital in Brussels after a prolonged nosebleed that doctors said was caused by hypertension, an official said Thursday, Oct. 23, 2014. Cyprus government spokesman Nicos Christodoulides said President Nicos ...
 
Forbes
Fri, 24 Oct 2014 12:45:14 -0700

Netflix (NFLX) reported earnings last Wednesday, and disappointing subscriber growth numbers promptly caused the stock to plummet 20%. Loads of new competition will continue to kill the company's margins. The company cannot raise prices without ...

WSAV-TV

WSAV-TV
Fri, 24 Oct 2014 10:37:30 -0700

It happned when one of the passengers developed a nosebleed. EMS crews were called in and they were preparing to get into hazmat suits. Officials questioned the passenger and dertemined that he had not visted any West African countries and therefore ...

Scotsman

Scotsman
Mon, 29 Sep 2014 09:13:09 -0700

The incident in Orkney on 30 November last year was reported as a “clinical care” issue, resulting in death by epistaxis, or nosebleed. Adverse events are “any unexpected or avoidable event that could have resulted, or did result, in unnecessary ...

India West

India West
Thu, 25 Sep 2014 12:37:07 -0700

But Saraiya doesn't recommend sticking pork up one's nose for a routine nosebleed, as it could cause an infection. Saraiya has an M.D. from Topiwala National Medical College at the University of Mumbai and did her fellowship in pediatric otolaryngology ...

Chron.com

WWSB ABC 7
Thu, 18 Sep 2014 17:45:00 -0700

Gary Dryfoos demonstrates the effectiveness of packing strips of cured pork in his nose to stop uncontrollable, life-threatening nosebleeds during a performance at the Ig Nobel Prize ceremony at Harvard University, in Cambridge, Mass.,Thursday, Sept.
 
Baltimore Sun
Thu, 02 Oct 2014 17:51:29 -0700

Orioles fans, from left, Ray Chesser, 65, of Florida; Karen Hill, 49, of Abingdon; Denise Hill, 44, of Baldwin; Shaun Kupfer, 26, of Sykesville, and Robbie Mathias, 26, of Sykesville, enjoyed the game from Section 306, Row 25--among the farthest from ...
Loading

Oops, we seem to be having trouble contacting Twitter

Support Wikipedia

A portion of the proceeds from advertising on Digplanet goes to supporting Wikipedia. Please add your support for Wikipedia!

Searchlight Group

Digplanet also receives support from Searchlight Group. Visit Searchlight