What is Epistaxis?
Epistaxis, commonly known as a
nosebleed, is a medical condition where bleeding occurs from the nostrils, nasal cavity, or nasopharynx. It is a frequent occurrence and can range from a minor inconvenience to a major emergency.
Causes of Epistaxis
Epistaxis can be caused by various factors, which can be broadly categorized into
local and
systemic causes. Local factors include trauma to the nose, dry air, infections, and nasal tumors. Systemic causes often include bleeding disorders, hypertension, and the use of certain medications like anticoagulants.
Types of Epistaxis
There are two main types of epistaxis:
anterior and
posterior. Anterior epistaxis is more common and usually less severe, involving the blood vessels at the front of the nose. Posterior epistaxis, although less common, can be more serious as it involves larger blood vessels located at the back of the nasal cavity.
Assessment in Nursing
When assessing a patient with epistaxis, nurses should take a comprehensive history and perform a thorough examination. Key aspects to address include: Severity: Assess the amount and duration of bleeding.
Medical History: Check for any underlying conditions such as bleeding disorders or hypertension.
Medications: Identify any medications that may contribute to bleeding, such as anticoagulants.
Physical Examination: Inspect the nasal cavity to locate the source of bleeding.
Initial Nursing Interventions
Immediate interventions are crucial to manage epistaxis effectively. Key steps include: Encourage the patient to sit upright and lean forward to prevent blood from entering the
throat.
Apply pressure to the soft part of the nose for at least 10-15 minutes.
Use a cold compress on the nose and cheeks to constrict blood vessels.
Advise the patient to breathe through their mouth and avoid speaking or swallowing excessively.
Advanced Nursing Interventions
If initial interventions are not effective, more advanced measures may be required: Nasal Packing: Inserting gauze or a nasal tampon to apply direct pressure to the bleeding site.
Chemical Cauterization: Using a chemical agent like silver nitrate to seal the bleeding vessels.
Electrocautery: Applying electrical current to cauterize the bleeding area.
Referral: In severe cases, refer the patient to an ENT specialist.
Patient Education and Prevention
Nurses play a crucial role in educating patients on how to prevent future episodes of epistaxis: Advise on maintaining a humid environment to prevent nasal dryness.
Educate on the proper use of nasal sprays and avoidance of
nasal trauma.
Discuss the importance of managing underlying conditions such as hypertension.
Highlight the need for regular check-ups if the patient is on anticoagulant therapy.
The bleeding persists for more than 20 minutes despite applying pressure.
They experience recurrent episodes of epistaxis.
There is significant blood loss or they feel lightheaded and weak.
They have known bleeding disorders or are on anticoagulant therapy.
