Nose bleeds

This leaflet is for patients who have a nose bleed as an outpatient or as an inpatient (needing a hospital stay). It explains:

• what causes a nose bleed

• what treatments are available

• what happens if I have to stay in hospital, and

• how to manage nose bleeds at home.

If you have any questions, please contact Rotary Ward.

What are nose bleeds? And, what causes them?

Epistaxis (nose bleed) is common. The bleeding is usually minor but can be life-threatening.

In children and young adults the bleeding can easily be stopped. In this group, the most common causes of epistaxis are:

• slight trauma (accident or injury), or

• infection, for example a cold.

In middle age or elderly patients, the bleeding tends to come from far back in the nose and is more difficult to stop.

What treatments are available?

As you will be receiving emergency treatment for your nose bleed, the on-call doctor will decide which treatment you will have.

• If the doctor can see the bleeding point, they will cauterise it. Cauterisation is done with a chemical stick or an electric probe placed directly on the bleeding vessel, sealing it. This procedure can cause some pain in your nose for a short time. Your doctor may prescribe some cream for you to apply twice a day.

• The doctor may place packing inside your nose for at least 24 to 48 hours.

A sample of your blood will be sent to the laboratory to check your blood loss.

A transfusion is rarely needed.

Will I have to stay in hospital?

You will be admitted to a ward and advised to rest on the bed. You may be given a relaxant, either as a tablet or injection.

If your nose does not bleed for the next 24 to 48 hours, the packs may be removed. Your doctor will examine your nose, and probably say you can go home after a few hours or the next day.

Are there any alternatives?

If you do not accept the advice given by your doctor, all you can do is rest and pinch the soft part of your nose. Hold an ice pack over your forehead, until the bleeding stops. The bleeding may return several times.

What will happen during my stay in hospital?

• As your nose is packed and you are breathing only through your mouth, your mouth will feel very dry. You will be offered mouthwashes and encouraged to drink plenty of cool fluids.

• Rest as much as possible.

• If you bleed again, more packing will be placed inside your nose until the bleeding stops.

What will happen when I go home?

• Do not place anything inside your nostrils, even tissues; this can cause infection.

• Do not blow your nose for one week.

• Use any cream inside your nose, that your nurse or doctor have prescribed.

• Slowly get back to carrying out your normal activities.

• Avoid becoming constipated, and needing to strain.

• Avoid straining by lifting heavy objects, gardening, or doing energetic sports for 1 to 2 weeks.

• Nasal obstructions and swelling could continue until your nose has completely healed, and this might take some weeks.

• If your nose bleeds or pain continues, contact your GP or nearest Emergency Department immediately.

Further information

If you have any questions, please telephone the Rotary Ward.

• Rotary Ward, William Harvey Hospital, Ashford
  Telephone: 01233 616234