The nose is the main gateway to the respiratory
(breathing) system. The inside of the nose is covered with mucosa
(moist, soft tissues) that has a rich blood supply. This warms and
moistens the air we breathe. Air passes to and from the lungs through
the nostrils. A thin flexible wall called a nasal septum separates the
two nostrils. Diagnosis:
Little's Area- it is situated in the anterior inferior part of nasal septum. Four arteries anastomose here to form a vascular plexus called 'Kiesselbach's plexus'. This area is exposed to the drying effect of inspiratory current and to finger trauma and is the usual site for epistaxis in children and young adults.
It is defined as a bleeding from inside the nose. It can present in any age group. It is a sign not a disease and an attempt has to be made to find out the cause behind it. Epistaxis is often a frightening sight to the patient and the attendants, especially if the patient is a child.
nail trauma, injuries to nose, fractures of middle third of the face,
Acute- viral rhinitis, nasal diphtheria, and acute sinusitis.
Chronic- Atrophic rhinitis, rhinitis sica, tuberculosis, granulomatous lesions like rhino-sporodiasis, syphilitic nasal septum perforation.
Living and non-living.
of nose and paranasal sinuses
changes- High altitude and sudden compression
mitral stenosis are commonly seen in old age
Fexofenadine/Allegra/Telfast, warfarin, ibuprofen, clopidogrel,
isotretinoin, desmopressin, ginseng and others
(due to vasodilation)
by mambas, taipans, kraits, and death adders
failure (due to an increase in venous pressure)
C or Vitamin K deficiency
the cause of Epistaxis is not clear
the blood is coming out from the front of nose with the patient in
sitting position. Mostly occur in children or young adults. Bleeding is
usually mild, and can be controlled by local pressure
times, the blood flows back into the throat. Patient may swallow it and
later have a "coffee coloured" vomitus. This may erroneously be
diagnosed as haematemesis. It commonly present after 40 years of age
1.Clinical history- to detect any injury.
2.Physical examination with the help of nasal speculum.
a.Make the patient sit up with a backrest and record any blood loss-taking place through spitting and vomiting.
b.Reassure the patient.
c.Don't panic because most of the time bleeding can be controlled by pinching the nose tightly for about five minutes.
d.Ice compress can be applied in the nose. They cause bleeding blood vessels to constrict & bleeding stops.
e.Keep check on pulse, BP and respiration.
g.Investigate and treat the patient for any underlying local and general causes.
i.Surgeries in emergencies.
j.Homoeopathy- the medicine is selected on the basis on the symptoms similarity and underlying cause. The epistaxis can also be treated safely and effectively with homeopathic medicines. Homoeopathic remedies selected after properly studying the patient's case are very effective in stopping epistaxis without any relapse.
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