Friday, April 30, 2010
What to do and what not to do for a bloody nose
One morning before the crack of dawn I had a relative call me in a panic. "Jane woke up vomiting large amounts of blood. What should I do?"
Me: "Take her to the emergency room."
"I don't want to do that. What else can I do?"
Me: "I am not a doctor. Even if I was, I am not close enough to do anything for you. Even if I was, I would still tell you to go to the emergency room."
A few hours later I called to check back. They decided not to go to the emergency room. Said relative decided that Jane had gotten a bloody nose in her sleep (which she was prone to do) and since she was laying on her back, it dripped down her throat and into her stomach, and the quantity was large enough that it made her vomit. The same thing can happen if you tilt your head back when you get a bloody nose. Which is what I was taught to do and what I always saw everyone else do when someone got a bloody nose. It is better to get a few drops of blood on your clothing, than to vomit blood all over who knows what. When you lean forward into a tissue the blood is will more quickly dry and clot, whereas when you tilt your head back the blood is flowing through a warm humid area (the throat) and won't clot off as fast. Most nose bleeds originate near the front of the nose, so pinching the nose and holding pressure usually will stop the bleeding. And once the blood does clot, don't try blowing the clots out, you can start a fresh bleed. If you have been holding pressure for twenty minutes or more and your nose is still bleeding, seek medical intervention. A continuing nose bleed can be a sign of a skull fracture or a symptom of other illnesses.
Nose bleeds can be caused by many things. Any medication that thins the blood (ibuprofen, aspirin, coumadin, etc.) make you more susceptible to getting a bloody nose. As do hot, dry climates (hello, St George, UT) cold climates (the your heater dries out the air), illness and infection. When your nose is dry, cracked or irritated it is more likely to bleed. When I was in nursing school one of my instructers taught us a simple secret to help prevent us from getting sick, as we would be exposed to so many illnesses in our clinicals. (And we were generally stressed out and sleep deprived which doesn't help your immune system.) The secret is nasal saline. You can buy it over the counter or you can make your own. Whichever method you choose, squirt a small amount in each nostril as often as it takes to keep your nose slightly moist. In order for your nasal mucous to most effectively trap bacteria and viruses, it must be moist. Moist mucous membranes in your nose means fewer illness and fewer nose bleeds.