Nose Bleed (Epistaxis) Regimen

1. Nose bleeds occur after the mucus membrane (skin) of the nose is disrupted. Because the blood vessels of the nose are right beneath the surface, bleeding occurs.

2. Aspirin and ibuprofen (Motrin/Advil) should be avoided as they can cause bleeding.

3. Dryness in the nose can cause bleeding. The best way to stop bleeding in the nose is to prevent the nose from getting dry. Saline spray should be used, 3 puffs in each nostril 4 times a day. Vaseline on a Q-tip should be gently place in the nose (wherever you can comfortably reach) three to four times a day. If you have a humidifier, this should be used in the bedroom at night.

4. If you have high blood pressure this can also promote bleeding from the nose. You should consult your internist regarding your blood pressure if this has not been checked or it is not completely under control, Diabetes and arteriosclerosis can also predispose you to nose bleeds.

5. For 3 days follow this regimen to prevent further bleeding.  Get Afrin and Neosynephrine nasal decongestants found over the counter in your drug store.  The 1st day use these alternating every 4 hrs, then the next day, alternate every 8hrs, then the next day, alternate every 12 hrs.  After completing this 3 day regimen, stop using these nasal sprays.  If your nose is actively bleeding you should take Afrin and soak two pieces of cotton with this. Then place the cotton in each nostril and pinch the front of your nose for five minutes without letting up the pressure. Do not use Afrin on a daily basis, use it only if there is actual bleeding. If after doing this your nose still bleeds, you should go to the nearest emergency room so that your nose can be packed. If the emergency room doctor has difficulty, they will then call our office.

6. Packing will usually stay in the nose for 48 hours. Cauterization of the nose is sometimes necessary in addition to the packing. If your nose bleed is especially difficult to stop a posterior balloon packing may be placed, you will have to remain in the hospital if this is used.