A Conversation for Nose Bleeds
Epistaxis
amdsweb Started conversation Aug 30, 2000
The nose bleed, or epistaxis as doctors tend to call it (to make themselves sound important) is very messy, and is due to the unusually rich and delicate blood supply to the bit separating your nostrils.
If your first aid doesn't stop a nosebleed and you have to go to hospital, here is what will happen:
1) Your friendly A&E doctor will press your nose for 15 minutes, despite the fact that you tell him that you just did that and it didn't work. When that doesn't work, the A&E doctor will scratch his head, mutter something, and call the Ear Nose & Throat surgeon.
2) The good surgeon will then stick what looks a bit like a cotton bud (called a pledget) up your nose. This will probably be soaked in a solution of adrenaline or neosynephrine. The aim is to make the blood vessels in the nose constrict.
3) The pledgets are removed and the surgeon will hurriedly peer up your nose to look for the bleeding site. Once located, the site will be cauterised with silver nitrate.
4)The surgeon will produce with a flourish from a top hat a large roll of gauze, approximately 1cm wide and 1 metre long. This is called BIPP packing and, you will be pleased to hear, it goes up your nose. All of it. As you can imagine, it takes quite a bit of time and patience.
5) If that doesn't help, extra packs are put up the nose from the back (ie at the back of your throat). Alternatively the surgeon may insert a balloon into your nose and inflate it. Packing and balloons are basically great ways of applying pressure.
6) The packs are left up for 3 days. On removal they are quite manky.
7) If you start bleeding again when the packs come out, you have a problem. The surgeon will mutter expletives under his breath and whisk you off to the operating theatre. There he will rummage about in your face, trying to find the artery that supplies to nose bleed. He will then tie off that artery. If he can't find the source, he will just tie them all off.
Hope that has reassured you all.
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Epistaxis
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