EPISTAXIS

DEFINITION:-

Bleeding from the nose is called epistaxis. It is not a disease but it is a symptom of other disease.

CAUSES/RISK FACTORS:-

  • Congenital
  • Injury to nose
  • Hot environment
  • Acute rhinitis
  • Chronic rhinitis
  • Sinusitis
  • Nasal diptheria
  • T.B
  • Syphilis
  • Adenoiditis
  • Nasal mucosa dryness
  • Nasal cancer.
  • Haemophilia
  • Trauma in brain
  • Malaria, Typhoid, Measles, Influenza
  • High arterial pressure
  • Whooping cough
  • Diabetes mellitus
  • Malnourishment
  • Lack of Vit.C and Vit.K
  • medicines (Aspirin)


SIGN/SYMPTOMS:-

  • Bleeding of Nose.
  • If patient swallow blood, then blood comes out through vomiting.
  • Fresh bright and red blood.
  • Unconsciousness in case of severe bleeding.


COMPLICATIONS:-

  • Rhinitis
  • Otitis media
  • Maxillary and frontal sinusitis
  • Shock.


MEDICAL MANAGEMENT:-

  1. With anterior bleeds, the patient is instructed to compress the soft part of nose with index finger and thumb for 5-10 minutes to maintain pressure on the nasal septum.
  2. A coatted pledget soaked with a vasoconstricting agent may be inserted into each nostrils.
  3. Cold nasal packing apply.
  4. Adrenaline hydrochloride 1:1000 cotted pledget inserted into nostrils.
  5. The blood vessels may be cauterized.
  6. If bleeding continuous or posterior bleeding is initially identified, packing may be layered into nasal cavity and nasopharynx or balloon tamponade may be required to apply pressure over a larger area.
  7. In condition of high blood pressure, advice patient to open mouth and sit upright with forward head down position, avoid accumulation of blood in throat and give antihypertensive drugs.


NURSING MANAGEMENT:-

  1. Provide Vit.C and Vit.K orally
  2. Check B.P., Pulse, Respiratory Rate.
  3. HB test should be done
  4. Provide complete bed rest
  5. Maintain fluid electrolyte balance.
  6. Antibiotics therapy for recurrent secondary infection.
  7. Maintain suitable environment to patient.

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