• Nasal bleeding in adults: causes, treatment and first aid

    The mucous cavity of the nose is rich in blood vessels. Sometimes, for some reason, the integrity of the blood vessels can be compromised. Thus, nosebleeds occur.

    To determine the presence of nasal bleeding is easy, if the blood begins to flow through the nostrils. But the blood can begin to flow down the back wall of the pharynx, often falling into the stomach, which causes the development of additional symptoms.

    Nasal bleeding very rarely leads to serious complications and even more so to death.

    Causes of nasal bleeding in adults

    The causes of nasal bleeding are divided into two large groups, namely:

    • local factors;
    • system factors.
    Local - these are the factors that directly affect the blood vessels in the nasal cavity. Thus, the most frequent nasal bleeding caused by a nasal trauma after a stroke, a surgical operation or diagnostic manipulation, as well as the development of acute inflammatory processes in the nasal cavity. In addition, nasal bleeding in adults occurs due to tumors of the nasal cavity, anatomical deformities, inhalation of drugs and corrosive substances. Sometimes dry air, especially in the long winter period, can cause nasal bleeding.
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    System factors are those causative factors that do not damage blood vessels, but mostly affect them from the inside as various diseases. So, diseases of the cardiovascular system, allergies, various rhinitis, blood diseases, hypovitaminosis and vitamin deficiencies, hormonal imbalances, systemic connective tissue diseases and many other diseases can cause the development of nasal bleeding.

    Classification of

    There are several classifications of nasal bleeding. By localization, isolate:

    1. 1) Anterior bleeding, in which the vascular plexus is affected in the anterior part of the nose. The blood in this case flows out of the nostrils rather intensely, but it stops quickly if you give the person first aid.
    2. 2) Back bleeding, which affects the vascular plexus in the back of the nose. Blood in this case usually flows down the throat and can get into the stomach. Bleeding of this type rarely stops on their own, as the vessels of the posterior part of the nose are rather large. This condition can pose a threat to life, so a person needs medical help.
    3. 3) Unilateral bleeding, which is characterized by the flow of blood from one nostril.
    4. 4) Bilateral, in which blood flows from two nostrils.
    There is another classification that divides nasal bleeding by the volume of blood loss. So, allocate:

    • insignificant, which can arise as a result, for example, of a remark;
    • moderate, with a volume of up to 200 ml;
    • massive, with a volume of more than 200 ml;
    • profuse, with a volume of more than 500 ml.
    Massive and profuse nasal bleeding requires immediate treatment of the patient to the doctor, as the causes of such bleeding are quite a lot and the blood may not stop on its own. In addition, extensive blood loss leads to the development of menacing symptoms in view of the onset of hemorrhagic shock.

    Clinical picture of nasal bleeding

    Clinical manifestations of epistaxis are specific. In humans, depending on the part of the nose in which the blood vessels are affected, there is blood flowing from the nostrils or flowing down the back wall of the pharynx.

    In most cases, nosebleeds occur suddenly, only occasionally a person can note the presence of harbingers, such as itching and burning in the nose, headache, dizziness.

    Minor blood loss does not affect the patient's condition. If the blood goes on for a long time and its volume does not decrease, symptoms such as weakness, noise and ringing in the ears, dizziness, stomach pain, nausea, palpitations, paleness of the skin can occur.

    Further hemorrhage can lead to hemorrhagic shock, which manifests itself in the confusion of a person's consciousness, tachycardia and a sharp drop in blood pressure. This condition is dangerous and requires an urgent hospitalization of a person.


    Diagnosis of nasal bleeding in most cases is not difficult. First of all, the doctor prepares an anamnesis of the disease, which allows you to find out important diagnostic information, for example: the incidence of cases, possible injuries, concomitant diseases, the amount of blood lost, the appearance of symptoms of massive blood loss, etc.

    A general examination of the patient is conducted to identify signs of blood loss, bruises, injuries, obvious pathologies, as well as determining blood pressure and the general state of a person.

    In some cases, nosebleeds are not at all nasal. Blood can flow into the nasal cavity from the larynx, trachea, lungs and even from the middle ear, so determining the source of bleeding becomes a top priority. For this, such examinations as rhinoscopy, endoscopy of the nasal cavity, pharyngoscopy are necessary, which allow us to determine not only the severity of the bleeding, but also its source.

    In addition, a person must necessarily make a general blood test to monitor the condition, determine the presence or absence of anemia and conduct a coagulogram that allows you to analyze the coagulability of the blood.

    Treatment and first aid for nasal bleeding

    A person with epistaxis may need first aid, whose tasks are limited to stopping blood loss.

    1) For this it is necessary to seat the person, asking him to tilt his head forward. It is a great delusion that when bleeding, you need to throw your head back. Such a statement is fundamentally incorrect, since in this case the blood will begin to flow down the throat to the stomach or airways. That's why the head must be kept tilted forward. It is possible to squeeze the nose with your fingers to press down the source of bleeding.

    2) You can also apply a cold compress or ice to the nose, especially in case of a nasal injury. If the blood does not stop after performing these actions, it is recommended that the cotton wool soaked in the vasoconstrictor is placed in the nostrils. It should be noted that in no case should you use vasoconstrictive drops for the nose.

    3) If bleeding does not stop after applying the above methods, you should consult a doctor. Severe cases of nasal bleeding are stopped in a hospital by the thermal or chemical cauterization of a bleeding vessel. Surgical operations for this purpose are rare.

    The subsequent treatment of nasal bleeding depends on the causes of the onset, on the incidence of cases and the concomitant human diseases.

    Complications of

    All complications of nasal bleeding are reduced to the development of conditions that occur against the background of acute blood loss.

    Oxygen starvation of the central nervous system and internal organs very quickly develops, cardiovascular system is disrupted, blood pressure decreases, tachycardia arises.

    A person with a hemorrhagic shock hardly reacts to external stimuli, possibly delirium and confusion. To treat blood loss, use a wide range of drugs that are designed to normalize the patient's condition and make up for blood loss.

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