NOSEBLEED: WHAT TO DO, WHAT NOT TO DO

The Adventures of Pinocchio (1996 film)
The Adventures of Pinocchio (1996 film) (Photo credit: Wikipedia)

I don’t know if you ever watch the TV show Frasier but one of the main characters, Frasier’s brother, was said to have a nosebleed every time he tells a lie. You see him reaching for his nose when he makes up excuses. It is like a modern version of Pinocchio. It gave me the idea to look into it and gather some common sense advice. First, let’s review a few basics.

Definition: the medical term for a nosebleed is epistaxis. It is generally not a severe condition but it can cause a problem when it happens often, especially in young kids and it can also frighten them. It is caused by the rupture of the capillaries of the nasal mucous membrane when those small vessels become dilated, which is the case in hay fever. The nasal mucous membrane is highly vascularized and that is what makes it more prone to bleeding.

Most frequent causes:

  • dry air
  • change in altitude (airplanes, hiking, etc.)
  • trauma (scratching or external trauma)
  • crusty rhinitis (that can be associated with scratching to remove the crust)
  • certain medicines that have an anti-coagulation effect (aspirin, blood thinners), and certain blood diseases
  • some health conditions such as hypertension, diabetes, etc.
  • Like in the TV show, there could also be a psychological component that triggers the episodes in someone who has more fragile capillaries.

What are the signs: They are very obvious and the blood generally comes from the front part of the nose (anterior nosebleed) and it stops after a few minutes. In some rare cases, the bleeding comes from the bigger blood vessels that are in the back part of the nose (posterior nosebleed) and those can be dangerous. They usually happen after an injury and in older people regularly taking aspirin or blood thinners or suffering from hypertension or renal insufficiency.

 

Here is some advice on what to do and what not to do in cases of common and non threatening nosebleed:

  • Blow your nose very gently to evacuate clots.
  • Avoid physical efforts and sit down. While seated rest your elbow on a table and apply pressure on the nostrils with your thumb and index finger for approximately 5 to 10 minutes.
  • Put an ice cube at the root of the nose.
  • Calmly breath through your mouth.
  • Spit out any blood that drips into your mouth instead of swallowing it as it would make you nauseous.
  • Apply a nosebleed dressing inside the nostrils if necessary at this point. You can use a specific dressing or if you do not have any, use a piece of gauze.
  • Rest for at least one hour.
  • In all case, do not panic!
  • Last, be aware that some people do not handle the sight of blood well and might faint and hurt themselves. That is why you should always make someone with a nosebleed sit.

And here are things to avoid:

  • One of the things that the Frasier character does is tilt his head upward and walk around for comical purpose. In real life, this is not a good idea as you could swallow or, even worse, inhale blood. On the contrary, sit down and tilt your head downward. If you cannot contain the bleeding with a tissue right away, bend your head over a bowl and spit out the blood. Then compress your nose to stop the bleeding that should happen within a few minutes.
  • Once you have evacuated the clot(s) do not blow for at least 4 hours.
  • Of course, if all those measures do not make the bleeding stop within 10 minutes, or if the bleeding is abundant, call your physician or go to the ER. In any case it would be a good idea to consult a physician afterward to seek what caused the episode.

For people who are more prone to nosebleeds, such as children and the elderly, here are a few extra precautions:

  • Try to maintain a cool temperature in your bedroom. This makes the air less dry. You can also use the tip I gave in my post about allergies and put a bowl of water next to your bed at night.
  • Hydrate the mucous membrane in your nostril by applying a thin layer of Boiron Calendula Ointment. You also can do nasal irrigations with saline solution but be cautious and do it very gently.
  • Avoid aspirin unless prescribed by your physician.
  • You should be careful even with certain herbs and food such as Ginkgo, ginseng, hamamelis and horse-chestnut, which is used to help with varicose veins and bad leg circulation.
  • Stay away from alcohol and hot beverages when possible. Smoking should also be avoided.

Let’s see what homeopathy can do for us in this situation:

There are many different homeopathic medicines that can be indicated for a nosebleed according to its characteristics in each patient. I only selected three that are frequently used:

Arnica montana 6C or 12C: In all cases take 5 pellets 2 times a day for a few days.

Ferrum metallicum 6C: This is especially useful for a nosebleed related to rhinopharyngitis and accompanied with a mild fever. If this happens regularly, take 5 pellets 3 times a week for 3 months.

Phosphorus 6C: If a nosebleed happens without a history of previous episodes and without obvious reason, take 5 pellets every 10 minutes for an hour.

 

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