Epistaxis: Are you still looking up to stop bleeding by mistake?

Epistaxis is a common condition in almost everyone’s daily life. It is one of the most common symptoms of nasal and sinus diseases, and may also be a manifestation of some systemic diseases. Epistaxis can be mild or severe. Mild people are only slightly bloodshot in blowing your nose in the morning. Severe massive hemorrhage can even lead to life-threatening dangerous situations such as hemorrhagic shock and asphyxia. Why is nose bleeding? Generally speaking, the nose is mainly composed of a nasal cavity that runs through each other, four groups of surrounding sinuses (frontal sinus in forehead, ethmoid sinus in inner canthus, sphenoid sinus behind eyeball and maxillary sinus above alveolar bone under orbit), and nasopharynx behind. The nasal cavity is divided into two parts by the middle nasal septum, which is the nasal beam bone. At the nasopharynx, they merge into one. The whole nasal cavity is covered with mucosa. There are blood vessels in the mucosa, Therefore, a broken mucosa often causes epistaxis. Possible causes of epistaxis include local causes of nose. It mainly refers to epistaxis caused by inflammation of nasal cavity and sinus and its surrounding structures (rhinitis, sinusitis, nasopharyngitis, etc.), trauma (nasal digging, rubbing, blowing nose hard, falling, etc.), tumor, deformity (nasal septum deviation, etc.), foreign body (common in children), etc. Apart from nose, It is also possible to cause systemic diseases. One of the classic passages of the TV series is that the hero has a bleeding nose. As a result, a check is the plot of leukemia. As long as the whole body etiology can cause blood pressure to increase, Epistaxis can be caused by coagulation dysfunction or brittle blood vessels. Common diseases include cardiovascular diseases, hematological diseases, chronic diseases such as liver and kidney, poisoning, endocrine disorders, etc. Epistaxis that can be handled by itself will not cause too much hemorrhage in most patients. It is mainly manifested as bloodshot in nasal discharge, There are blood streaks or blood on the paper towel or cotton ball stuffed into the nasal cavity. Or blood drips from the nostrils but the speed is not fast and continuous. A little compression or no treatment will stop on its own. These conditions are common in bleeding in the anterior part of the nasal cavity. Because there’s a vascular plexus over there, Due to dry weather, chronic rhinitis and other causes of nasal mucosa congestion, thinning, In addition, nose digging, blowing your nose hard, sneezing violently, etc. lead to congestion, mucosal erosion or injury and bleeding, Children with this kind of situation are more common. 1. Patients with small amount of compression hemostasis can achieve the effect of compression hemostasis through rest, gently pressing from both sides of nostrils to the middle nasal beam bone, or filling cotton balls in nasal cavity for a few minutes. However, in daily life, paper towels or cotton balls cannot be often stuffed into nasal cavity to wipe nasal mucus, scratching, etc. Because repeated friction will damage nasal mucosa and cause epistaxis, Make the original epistaxis aggravate or endure for a long time. 2. Bow your head, It is not to raise one’s head and lift one’s head up, but to make the blood originally flowing from the nostrils flow back through the nasopharynx to the mouth. Or swallow it into the stomach, It seems that the amount of bleeding has decreased. In fact, it only changes the blood flow route. Swallow may cause digestive tract irritation symptoms. 3. Apply cold towel to the head and apply cold water bag or wet towel to the forehead and back neck. Can promote vasoconstriction, So as to reduce bleeding. There are also some patients who have small hemangiomas at that location. Epistaxis often occurs repeatedly when sneezing, holding one’s breath or lifting heavy objects. Although the quantity is small, However, it is recommended to go to the hospital for further examination and treatment after hemostasis. If the blood drips continuously, Even become blood flow, That means the bleeding rate in the nasal cavity is not slow, At this time, you should consider going to the hospital. No matter whether the blood flows from one nostril, Or through the nasopharynx down to the mouth to spit out a lot of blood, Even from the contralateral nostril, This kind of rapid and large hemorrhage should be treated nearby immediately. This kind of massive hemorrhage, The bleeding point is usually located in the posterior part of the nasal cavity or nasopharynx. Self-hemostasis is ineffective, It may be a large blood vessel or hemangioma rupture and hemorrhage, Or the coagulation dysfunction caused by the above-mentioned systemic diseases. 1. Don’t swallow the bleeding. Pay attention to let the patient spit out the blood in his mouth as much as possible and don’t swallow it. On the one hand, it is necessary to avoid vomiting in the later period caused by stomach stimulation caused by swallowed blood, 2. Provide accurate information to that doctor in order to enable the doctor to quickly and accurately understand the patient’s condition, It is better for patients or their families to provide the following information more accurately: The time, frequency and inducement of epistaxis, the manifestation when it starts bleeding, If the blood first flows out of which nostril, First, whether it flows out of the anterior nostrils or spits out of the mouth, whether it has been treated and previous medical records, normal physical condition, medication, etc. 3. Routine treatment (1) Find bleeding points, Scalding: If the doctor passes the examination, Find the bleeding point smoothly, Generally, chromic acid will be used to scald off the bleeding point or electrocoagulation to stop bleeding. (2) No bleeding point can be found, Packing: However, not all epistaxis can be found or the cause of hemorrhage can be found clinically. When the bleeding point is not identified, Usually doctors will take the method of filling oil gauze through nostrils to stop bleeding, After packing, it needs to be maintained for 48-72 hours before going to the hospital to withdraw the packing. (3) What’s more, Surgical management: If nasal tamponade is still not effective in stopping bleeding in outpatient and emergency cases, Or if the bleeding point is located too far back to be handled in the clinic, Then you need to go to the operating room and conduct a comprehensive nasal exploration under endoscope. Looking for bleeding points, complete hemostasis. 4. Looking for causes in addition to clear nose local bleeding, doctors can diagnose whether there is hypertension, common cardiovascular system and blood system diseases and other systemic causes through blood pressure, electrocardiogram, blood routine, coagulation function and other examinations. How to prevent epistaxis? It is mainly aimed at epistaxis caused by local etiology of nose. Avoid picking your nose, rubbing your nose and blowing your nose hard. Keep moisture when the weather is dry. In addition to adding humidity to the air through humidifiers and the like, Some aureomycin ointment can also be applied locally to lubricate nasal mucosa. In particular, parents and friends need to be reminded that, At present, the incidence of allergic rhinitis in children is increasing day by day. Many children often dig and rub their noses due to nasal itching, Causing nosebleeds, Therefore, in addition to the treatment of epistaxis, primary diseases should also be actively treated so as to fundamentally avoid the recurrence of epistaxis. Epistaxis is a small matter and a big matter. When epistaxis occurs, there is no need to panic and fear. First, compression hemostasis should be carried out by oneself. If this method is ineffective or the amount of bleeding is especially large, you should see a doctor nearby in time. In addition, do not neglect epistaxis caused by systemic diseases.