Question

A wife phones the office stating that her husband is experiencing a severe nosebleed. The nose has been bleeding for about 20 minutes, and they cannot get it to stop. How do you handle this phone call?

Answer 1

Nosebleed( Epistaxis )

Usually the nose bleeds are due to unknown reasons, and sometimes asosiated with nosepicking and hypertension. This is usually non fatal and the bleeding usually stops by itself without any intervension of the physician.

Basic Anatomy :

The area is richly supplied by blood

1. Anteriorly by hesselbacks plexus (Littles area) - main supply is through sphenopalatine artery.

If the bleeding occurs through this area , the bleeding is Unilatera in nature that is it occurs through one nostril.

2. Posteriorly by Woodruffs plexus

If it occurs through this area, the bleeding is bilateral and severe. The blood can also flow back into the nasopharynx and the patient may aspirate the blood into the lungs and may become fatal

So We should ask the person whether the bleeding is Unilateral or bilateral. If unilateral, the patient should lie laterally for sometime and can be stopped by picking the cartilage and applying ice pack, but the person complained that it is severe so it is probably a posterior bleed, so we should advice the patient to bend to prevent aspiration of blood into the lungs and advice her to take his husand to the ENT emergency department.