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Occasionally nosebleeds occur in children and adults. Most often, it is not dangerous and has an apparent reason.

However, it often happens that the blood flows as if from scratch: nothing hurt, did not bother, but the blood suddenly began to flow.

What can it be, what to do and how to stop bleeding, is it necessary to have an examination and tests, which doctor should I go to?

Why might it arise?

The nose is important body feelings, due to it we feel all the aromas of life, it helps us to fight against the penetration of infection into the body.

There are many nerve endings in the nose and blood vessels, many of which are located in the area of the nasal septum just below the epithelial layer. Due to this position and the thin vascular wall, they can often bleed as a result of vascular damage. The causes of nosebleeds by doctors are divided into two large groups:

local processes associated directly with the area of the nose,
processes affecting the entire body as a whole.

Local causes

Local processes that can cause bleeding are injuries to the nose or its mucous membrane, this occurs when falls and blows to the face, nose fractures. Trauma to the mucous membrane often occurs in children due to the insertion of toy parts into the nose or injury from a fingernail or a sharp object to the mucous membrane.

Other causes can be inflammation in the nasal area or its sinuses, this is acute rhinitis, sinusitis and sinusitis with the formation of crusts in the nose and injury to the mucous membrane. With some inflammations in the nose, for example, allergies, blood flows to the vessels, and the vessels cannot withstand the pressure.

Curvature of the nasal septum or atrophy of the mucous membrane, various neoplasms in the nasal cavity also injure the vessels and cause bleeding.

Diseases of the whole organism

However, nosebleeds can also flow with serious illnesses the whole organism. So, nosebleeds occur in diseases of the heart and blood vessels, hypertension and atherosclerotic lesions in the vessels of the brain, circulatory disorders in cervical spine spine. Then the normal circulation of blood through the vessels is disrupted and the pressure inside the nasal capillaries increases, which they cannot withstand and burst.

Bleeding from the nose can become a symptom of blood clotting problems, including hereditary ones, an overdose of drugs that affect blood flow and clotting, with a deficiency of vitamins - for example, vitamin PP and C, which make the vascular wall strong.

Blood from the nose can go as a result of thermal effects on the body, this is possible when overheating in the sun, fever in infectious diseases. Nosebleeds can occur with a sharp change in pressure in climbers or divers, in case of imbalance of hormones, pregnancy.

Whatever the reasons that led to the development of bleeding, you must be able to provide first aid and decide whether you need help and advice from a specialist, whether you need to do it urgently, or you can consult a doctor as planned.

First aid measures

Usually, when bleeding from the nose occurs, we reflexively throw our head up, out of habit, pressing a handkerchief or napkin to our nose. Unfortunately, this is a common and dangerous misconception; you cannot throw your head up with nosebleeds.

This can result in blood being swallowed and inhaled, especially if severe bleeding, the occurrence of vomiting and obstruction (blockage of blood) of the bronchi. It is necessary to sit down and bend your head forward, looking between the spread legs, it is necessary for the blood to flow from the wings of the nose forward.

In addition, you need to calm down and give air access by unfastening a tight belt, shirt collar or a woman's bra. If bleeding occurs at home, placing a piece of frozen meat or ice cube on the bridge of your nose will narrow the blood vessels and stop the bleeding faster.

If the blood does not stop, you can press your nostril against the nasal septum for about ten minutes. By squeezing the vessels and slowing down the blood flow in them, a blood clot quickly forms there, which will clog the vessel.

If these measures do not help, you can try using vasoconstrictor drops, used for the common cold - naphthyzin, sanorin. After making a cotton swab and soaking it in the medicine, inject into nasal cavity as tightly and deeply as possible. If the bleeding is caused by dry crusts in the nose from a runny nose, it is necessary to lubricate the nasal cavity. vegetable oil or petroleum jelly, the crusts will soften and the bleeding will stop.

If nose bleed caused by overheating, it is necessary to take the victim into the shade and put a cool compress on the nose area. If you suspect heatstroke, you must immediately examine the person by calling ambulance and hospitalizing the victim.

When is medical help still needed?

Sometimes nosebleeds are one of the symptoms of serious illnesses, so you need to immediately seek help from doctors for:

suspicion of a fracture of the nose, with bleeding from the nose and a sharp deformity in the area of the nasal bone, swelling and pain.
if you experience bleeding from the nose in the background or after taking aspirin, heparin or any other medicines, especially hormonal.
with bleeding from the nose against a background of headache, darkening of the eyes or dizziness. When doing this, measure your blood pressure, go to bed, or sit down if you are out of the house.

It is necessary to call a doctor if the bleeding does not stop for more than fifteen minutes or if it intensifies, is accompanied by pallor and coldness of the extremities, loss of consciousness, or occurs against the background of a head injury.

See your doctor for tests and for recurring bleeding episodes with bruising, bruising, or bleeding of the gums. Another reason for contacting an ENT doctor is nosebleeds in a child or an adult, especially if you suspect a nosebleed. foreign body... Only a doctor can correctly and accurately remove the object and stop the bleeding.

If you have recurring nosebleeds, you will need to get a good check-up by your GP and ENT doctor. If necessary, they can send you to additional research- blood for the level of hormones, ECG or ultrasound of the heart. However, in most cases, bleeding episodes have visible and easily treatable causes.

Frequent nosebleeds in adults are a sign of any common disease: hypertension, atherosclerosis, liver cirrhosis, especially in patients with long-standing jaundice; one of the hemorrhagic diathesis - thrombocytopenic purpura (Verlhof's disease), hemorrhagic vasculitis, hemophilia, scurvy, Randu-Osler disease (multiple telangiectasias); diseases of the blood system (leukemia, erythremia,).

They are also caused by chronic nephritis, especially often in the final stage of the disease - with a shriveled kidney and uremia; diseases accompanied by stagnation of blood in the system of the pulmonary circulation and on the periphery (mitral stenosis, emphysema of the lungs, adherent pericarditis - "armored heart") and severe cardiovascular insufficiency; tumors of the nasal cavities (sarcoma, cancer, angioma, polyps).

Epistaxis in adults can also be caused by infectious diseases(influenza, malaria, scarlet fever, measles, typhus, especially typhus), sepsis. Of course, we must not forget about nosebleeds due to mechanical injury, overheating. The immediate cause of nosebleeds in adults is hypertensive crisis, physical and mental stress, as well as a decrease in atmospheric pressure ( altitude sickness) or a sharp drop in pressure (decompression sickness).

Symptoms of nosebleeds

In addition to the obvious discharge of blood, often in cases of nosebleeds, blood can flow into Airways, flowing down the pharynx and penetrating into the larynx. In this case, a cough occurs, with the release of blood, which is sometimes mistakenly diagnosed as.

More often blood is swallowed and enters the stomach, causing bloody vomiting, which is sometimes mistaken for stomach bleeding... Swallowed blood can later come out with feces, it turns black (melena).

Diagnostic errors are made primarily when nosebleeds occur at night, during sleep, in a supine position. Sometimes it is enough to ask the patient to blow his nose to establish the source of the bleeding. If in doubt about the diagnosis, an examination is required. It is important to establish the cause of nosebleeds, for which it is necessary to carefully and comprehensively examine the patient. For example, small, frequent nosebleeds in adults are the first sign of a formidable disease of the blood system or cirrhosis of the liver. In hypertension, nosebleeds are often vicarious in nature, relieve the patient's condition (relieve painful ones). Therefore, active intervention in order to immediately stop nosebleeds, apparently, is not always advisable. At profuse blood loss symptoms of acutely developed anemia appear: pallor of the skin, tachycardia, hypotension, dizziness, thirst.

Treatment of nosebleeds in adults

Peace is imperative. Semi-sitting position to keep blood from dripping and entering the airways. Cold on the nose and back of the head (cold water, ice pack). Introduction to the nose of gauze strips soaked in hydrogen peroxide (3% solution) or liquid vaseline oil. Sometimes nosebleeds can be stopped by pressing the wings of the nose (from the side of the lesion) with fingers to the nasal septum for 10-15 minutes. (this can be done by the patient himself) or by introducing a dense cotton swab under the tongue and pressing on the tongue from above with a finger.

A hemostatic sponge soaked in saline: it is inserted into the nose and pressed against the nasal septum with a finger.

In case of persistent bleeding, the patient must be admitted to the hospital: 10% calcium chloride is administered intravenously, vikasol intramuscularly, sometimes they resort to transfusion of plasma (50-75 ml) or whole blood (80-120 ml). Anterior or posterior (or both at the same time) nasal tamponade is also used, which is usually performed by an otorhinolaryngologist. The tampon is pre-lubricated with sterile vaseline oil or moistened with 1 ml of 0.1% adrenaline, 3% peroxide. You can use anti-tetanus, anti-diphtheria serum.

After stopping the bleeding, treatment is carried out for the disease that caused the onset of nosebleeds in an adult (hypertension, liver cirrhosis, leukemia).

The article was prepared and edited by: surgeon

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Blood Nose

Chances are, you don't worry too much about the trivial nosebleeds, which stops after a few minutes and the reason for which is obvious. Nose picking- the number one reason for such bleeding. Or if SOMEONE threw the ball too hard, and you caught it not with your hands, but with your own nose, a small trickle of blood will not bother you or confuse you. Or if your child has the amusing habit of sticking small pieces of toys up his nose to see how they fit in, again a little blood shouldn't surprise anyone. If you live in dry overheated house or spend a lot of time on airplanes (the air is dry, like in the desert), your nose can close on its own.

If you have recurrent nosebleeds, see your doctor even when the cause is obvious. Because there are many different local conditions, including swelling (rare), prolonged sniffing of caffeine, swollen, allergic membranes, nasal polyps (very common), and warts, each should be diagnosed and treated. The first thing a specialist will do is direct a light into your nostrils to look at the site of bleeding, a tiny vein or artery that has been irritated. If a vessel is found, cauterization (slightly painful, but necessary) will heal it and put an end to the bleeding. If such a vessel is not found, the examination will be expanded, including an X-ray or tomogram.

You can set from what location in the nose bleeding (but not why). To do this, pinch your nostrils and bend forward.

If the bleeding stops after about 5 minutes, the source is in front. But if the blood continues down the throat, then the artery on the pharyngeal surface of the nose is bleeding. In this case, the doctor will likely plug gauze or cotton wool over your nose to stop the bleeding, which is not a very pleasant procedure.

If your nose bleeds with no obvious local cause or injury and you're not spending a lot of time in dry air, check your blood pressure. In middle age and older, sudden onset of nosebleeds will indicate hypertension. If blood pressure OK, have your blood clotting system tested to see if it is working normally.

A word of caution: nosebleed after you've hurt your head, it could indicate a skull fracture.

An x-ray must be taken, no matter how trifling the blow you received may seem.

List of possible diseases:

Allergy An acute reaction of the body's immune system to usually harmless substances. Hypertonic disease Essential hypertension, a disease of the cardiovascular system, the main manifestation of which is an increase in blood pressure. Bleeding The cause of bleeding can be trauma with mechanical damage to the vascular wall, pathological changes in the composition of the blood or changes in the vessel wall itself, diseases of internal organs. Polyps Benign formations from the epithelium of the mucous membranes (nasal cavity, uterus, stomach, etc.). May ulcerate and bleed.

Epistaxis, or nosebleeds, is a fairly common phenomenon that occurs in both adults and children due to various diseases or other reasons. Visually, this manifests itself in the form varying degrees the intensity of blood flow from the nostrils.

Nosebleeds are divided into anterior and posterior. Separation is based on physiological features blood supply to the nose.

What are the nosebleeds?

In most cases, the source of bleeding is the Kisselbach plexus. Such bleeding is not dangerous, it stops on its own after 3-5-7 minutes.

The source of the most common anterior bleeding (in 90–95% of cases) is the Kisselbach plexus - a dense submucosal cavernous venous network with a mass of small capillaries and arterioles that supplies blood anterior section cartilage of the nose. Epistaxis from this area, as a rule, is not dangerous due to the small volume of blood loss. Blood flows out either in a thin stream or in drops. With normal clotting, bleeding stops on its own within a few minutes.

In 5-10% of cases of posterior bleeding, blood flows from the branches of large arteries in the posterior or middle parts of the nose. Bleeding from these arteries is profuse, may have serious consequences for health and even in rare cases lead to the death of the patient. Blood of a bright scarlet color flows out in a continuous stream. This bleeding does not stop on its own. Another manifestation of posterior epistaxis is the appearance of blood in the mouth and bloody vomiting arising from the ingestion of blood flowing from the nose through the pharynx into the oral cavity.

In some severe cases there may be bleeding from the orbit or the lacrimal opening, while the blood rises from the nose up the nasolacrimal canal.

Depending on the volume of leaked blood, several degrees of blood loss are distinguished:

Insignificant blood loss, in which from a few drops to several milliliters of blood is lost. Such bleeding is harmless to health and does not lead to any consequences. The only one negative point may be frightened, hysterical, or fainting in young children.
A slight degree of blood loss, the volume of blood in which does not exceed 700 ml in an adult, is not more than 12% of the total circulating blood. Such blood loss causes slight weakness, dizziness, rapid pulse and flashing of flies in front of the eyes. Blanching of visible mucous membranes and skin is possible.
The average degree is characterized by blood loss from 1000 to 1400 ml in an adult, which is up to 20% of the total circulating blood volume. It is accompanied by more pronounced symptoms in comparison with mild: weakness, dizziness, headache, thirst, shortness of breath.
Severe with massive bleeding. The volume of blood loss exceeds 20% of the total circulating blood in the body. Massive blood loss leads to hemorrhagic shock, expressed in a sharp drop blood pressure, lethargy, various violations consciousness up to its loss, insufficient blood circulation in internal organs... Of great danger are sudden, short-term, but massive bleeding, leading to large blood loss.

Causes of nosebleeds

Why is there a nosebleed? Let's consider the reasons. The factors causing nosebleeds are divided into local (local) and general (systemic).

Local factors:

Various .
Mechanical damage internal structures, which include the mucous membrane. Violation of its integrity can occur with inaccurate removal of dried crusts, from intensive scratching of the nose with a finger, rough repeated blowing of their nose, etc. Small children are very fond of sticking different foreign objects, thereby causing injury to the mucous membrane.
Barotrauma with a sharp drop in barometric pressure, typical for divers, pilots, climbers.
Congestion of the mucous membrane, its thinning or the effect on it of various drugs at inflammatory processes in the nose, such as for the flu, or chronic sinusitis... A particular risk when using a nasal steroid spray for treatment.
Inhalation of narcotic drugs, mainly cocaine through the nose.
Anatomical deformities of the nose. As an example, or telangiectasia caused by Rendu-Osler disease.
and . Oncological include nasopharyngeal carcinoma, benign - angiomas or.
Long-term inhalation of cold winter air. In this case, the low relative humidity of the air itself plays a role.
Heat or sunstroke from being under the scorching sun in hot weather.
Epistaxis as a consequence surgical intervention in the area of the nose.
Possible draining of the mucous membrane when using an oxygen catheter.

Systemic factors of nasal drip:

Arterial hypertension.
Vascular disease.
Congenital vascular pathology.
Diseases of the blood (leukemia, hemoblastosis, anemia, etc.).
Avitaminosis, mainly a lack of vitamin C and K.
Use alcoholic beverages, contributing to the expansion of blood vessels, including in the nose.
Heart disease accompanied by heart failure.
Connective tissue diseases.
Side effects from taking NSAIDs (non-steroidal anti-inflammatory drugs).
Diseases accompanied by blood clotting disorders, such as hemophilia.
Hemorrhagic diathesis.
Severe kidney disease.
Physical stress.
Heavy infectious diseases, including HIV infection, AIDS.
Hormonal changes in the body.

First aid for nosebleeds

With nosebleeds, do not throw your head back! On the contrary, it is necessary to slightly tilt the head and body forward and press the wings of the nose to the bridge of the nose with your fingers. It is advisable to put cold on the bridge of the nose.

A person who has nosebleeds can be helped before seeing a doctor. To do this, you need to perform a series of manipulations in turn:

First of all, sit the person down and lower his head slightly to ensure a good outflow of blood. If it is difficult for the patient to sit on his own, it is better to put him down, but raise the head end of the couch and turn his head to one side. A common folk measure, like throwing back the head, strictly prohibited... This will not stop the blood, but only can lead to undesirable consequences in the form of its penetration into the mouth, swallowing into the stomach, and in severe cases - entering the respiratory tract.
Provide inflow fresh air(unbutton your shirt, open the window).
Put an ice pack on the bridge of the nose. If bleeding through a short time does not stop, then you need to press the nostril, from which more blood flows, to the nasal septum for 5 or 10 minutes. It is prohibited to blow your nose. If blood gets into the mouth, spit it out.
If the above measures do not work, you can try to make a turunda or a tampon of sterile cotton wool, moisten it with 3% hydrogen peroxide or, for example, Sanorin, Naphtizin, Galazolin, Tizin. Insert such a turunda into the nasal passage and leave until the bleeding stops.
When epistaxis appears and the crusts formed after it, it is advisable to lubricate the tampon with petroleum jelly. Softening dry mucous membranes will help stop bleeding.
If nosebleeds are caused sunstroke, then the person must be transferred to a cool, well-ventilated place and put a cool cloth on the forehead and face, and ice on the bridge of the nose.

With massive bleeding resulting from a nose injury with a distortion of it anatomical structure, or in the case when it is impossible to stop the blood on your own, you need to immediately consult a doctor, and temporarily put cold on the bridge of the nose to relieve swelling.

Treating nosebleeds

After examination, determining the degree and cause of bleeding, the doctor chooses a method to stop it and, if necessary, further treatment.

Specialized health care consists of the following measures:

Nasal tamponade is a method of stopping nosebleeds by introducing tampons soaked in one of the hemostatic agents, for example, thromboplastin, into its cavity. A hemostatic sponge, which includes thromboplastin and thrombin, helps well.

Depending on the situation, the doctor makes an anterior tamponade - from the side of the nostrils, or a posterior one - from the pharynx.

Cauterization of bleeding vessels. There are many ways. Some acids - lactic, trichloroacetic or chromic acid - serve as a means of cauterization. Also used are zinc salts, alum, tannin, silver nitrate solution.
Highly efficient modern methods stopping nosebleeds is ultrasonic disintegration (deliberate destruction of the existing blood supply to hypertrophied turbinates using an ultrasonic waveguide), laser therapy (laser coagulation), exposure to liquid nitrogen (cold moxibustion), electrocoagulation (electrical burning).
At frequent bleeding accompanied by significant blood loss is indicated surgery, which consists in the ligation of large vessels and arteries, as well as in the detachment of the periosteum at the site of bleeding, leading to the desolation of the vessels.

It is important to know that nosebleeds are not always harmless. It is often a symptom of serious illness. If it's strong and for a long time does not stop, and even more often repeats itself, leading to a worsening of the condition, then it follows in mandatory consult a doctor for a detailed examination in order to determine the causes of epistaxis and to choose a method of qualified treatment.

Video version of the article:

The program "On the most important thing" tells about the causes of nosebleeds:

Blood from the nasal cavity is pathological condition, which can be observed by various reasons in people different ages... The most common factor that leads to nosebleeds is an increase in blood pressure.

Often everything ends well for the patient, without contacting the ambulance team, but in certain conditions, the doctor's intervention is indispensable.

The main causes of nosebleeds - what symptoms can nosebleeds be?

The phenomenon under consideration can occur spontaneously, regardless of certain diseases.

There are several factors that can provoke this condition:

Stay in direct sunlight for a long time.
Stressful state.
Excessive drinking. Alcohol favors the expansion of blood vessels, which affects the permeability of their walls.
A negative reaction of the body to taking certain medications.
Hormonal disruption in the body due to age-related changes(in adolescents), as well as during pregnancy.

Blood from the nose can be a specific pathology of some professions that are associated with changes in atmospheric pressure.

This risk group includes pilots, climbers, etc.

Local causes that can lead to nosebleeds include:

Injury to the nose from the outside, or from the side of the mucous membrane.
Pathological neoplasms in the nasal cavity / sinuses, at the base of the skull.
Fracture of the skull. In such incidents, the nose may also leak cerebrospinal fluid that has a white color.
Violation of the integrity of the internal carotid artery fragments of the bones of the skull.
Inflammation in the adenoids, sinusitis.
Dystrophic changes in the nasal mucosa. Similar transformations can occur in the background atrophic rhinitis either.

Epistaxis often develops against the background of a number of diseases, the main of which are:

Malfunctions of cardio-vascular system: hypertension, atherosclerosis of the blood vessels, various pathologies hearts.
Pathologies associated with the ability of blood to clot: platelet deficiency (thrombocytopenia), hemophilia, blood cancer, anemia. A lack of hemoglobin, a certain group of vitamins, causes blood thinning, and this negatively affects its clotting. The same group includes the Randu-Osler syndrome - congenital pathology vessels.
Serious defects in the functioning of the spleen, liver, kidneys.
Vegetovascular dystonia.
Infection of the body, which is accompanied by an increase in body temperature and intoxication: influenza, ARVI, scarlet fever, sepsis. Under the influence of harmful microorganisms, the walls of blood vessels become thin and fragile: they are able to pass blood components, which prevents its rapid clotting.
Thyroid pathology.

Types of nosebleeds according to the medical classification

Based on localization, nosebleeds are of two types:

Front... Do not lead to significant blood loss, and often they can be easily corrected without medical intervention... The source of the type of nosebleeds under consideration is the Kisselbach region, in which small blood vessels are concentrated.
Rear... Such bleeding occurs due to rupture of the walls of large vessels, which are located deep in the mucous layers of the nasal cavity. These bleeding cannot be stopped on your own: doctor's help is required. Otherwise, significant blood loss may occur.

Depending on the amount of lost blood, these bleeding are divided into three groups:

Mild severity... In comparison with the other two types of nosebleeds, this group is very common. In this case, the blood flows out in small drops, and it can be stopped by pressing the wings of the nose. Such bleeding does not carry any danger to life, however, if it lasts for a long period of time, the patient will complain of a loss of strength, slight dizziness.
Medium (moderate) nosebleeds... Due to the considerable volume of blood loss (300 ml), the patient's systolic blood pressure level decreases to 90-95 mm, the heart rate increases, skin turn pale.
Heavy bleeding... The amount of blood lost can exceed 1 liter, and if qualified assistance is not provided on time, the patient may die. General state the patient deteriorates sharply: systolic pressure drops to 80 mm, heart rate increases (up to 120 beats per minute), loss of consciousness, nausea, vomiting are possible. A blood test confirms a decrease in hemoglobin levels.

What to do with a nosebleed in an adult or child, how to stop the bleeding - first aid and actions for bleeding

When you open a nosebleed, you should do the following:

The victim needs, first of all, to calm down. To do this, you should monitor your breathing: it should be deep and slow. This will help minimize psychoemotional stress and lower your heart rate.
Follow correct position the patient's body. Better if he is sitting. However, in the absence of such an opportunity, it is necessary to slightly raise the head, but not to tip it back. Severe tipping of the head can cause blood to enter the stomach or airways. Such phenomena can provoke, respectively, vomiting or breathing disruptions. In addition, it is better if the blood flows into a certain container: this will help determine the volume of blood loss.

To stop mild nosebleeds, resort to the following measures:

Use your fingertips to press the wings of the nose to the bridge of the nose. Thus, mechanical compression of the blood vessels is ensured.
Instill nasal cavity with drops that contribute to vasoconstriction (pharmacoline, naphthyzine, etc.). Before this manipulation, the victim must blow his nose in order to get rid of the blood clots formed in the nasal cavity.
Drip the nose with 3% hydrogen peroxide solution. With a weak blood flow, a blood clot forms quickly enough and the bleeding stops.

In case of injury to the nose, the first aid algorithm is as follows:

Cold should be applied to the damaged area: this will help narrow the blood vessels. A similar effect will be achieved if you lower your hands in cold water... When using ice, take short breaks every 10 minutes to avoid frostbite.
Put your feet in a basin with warm water... Such manipulation will provoke the expansion of blood vessels in this part of the body, ensuring blood flow to lower limbs and unloading the vessels of the nasal cavity.

If it was possible to stop the bleeding, the patient in any case needs to see a doctor in order to examine the condition of the nasal bones on an X-ray machine.

In the absence of effectiveness from the use of the above methods for stopping bleeding, as well as in case of severe nosebleeds, it is necessary to make gauze turunda.

Before the introduction, it must be abundantly moistened in hydrogen peroxide or aminocaproic acid.

Since this process is very painful, the victim can first lubricate both halves of the nose. Lidocaine.