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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Nasal Bleeding In An Adolescent?

My son is 11. has been sick since thurs. dr said flu. He keeps getting nose bleeds and this one we cant seem to get to stop? stand/sit upright pinching just under the bridge if the nose. the blood is going down his throat and out his nose. what else can I do?
Thu, 4 Jan 2018
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General & Family Physician 's  Response
Hello. Nose bleed is called epistaxis in medical terms. If home remedies which you suggested doesnt work then you need to take him to doctor. I will tell you what measures are taken in hospitals.


Initial management includes compression of the nostrils (application of direct pressure to the septal area) and plugging of the affected nostril with gauze or cotton that has been soaked in a topical decongestant. Direct pressure should be applied continuously for at least five minutes, and for up to 20 minutes. Tilting the head forward prevents blood from pooling in the posterior pharynx, thereby avoiding nausea and airway obstruction. Hemodynamic stability and airway patency should be confirmed. Fluid resuscitation should be initiated if volume depletion is suspected.

Every attempt should be made to locate the source of bleeding that does not respond to simple compression and nasal plugging. The examination should be performed in a well-lighted room, with the patient seated and clothing protected by a sheet or gown. The physician should wear gloves and other appropriate protective equipment (e.g., surgical mask, safety glasses). A headlamp or head mirror and a nasal speculum should be used for optimal visualization.

When posterior bleeding is suspected, the general location of the source should be determined. This step is important because different arteries supply the floor and roof of the posterior nasal cavity; therefore, selective ligation may be required

Diffuse oozing, multiple bleeding sites, or recurrent bleeding may indicate a systemic process such as hypertension, anticoagulation, or coagulopathy. In such cases, a hematologic evaluation should be performed. Appropriate tests include a complete blood count, anticoagulant levels, a prothrombin time, a partial thromboplastin time, a platelet count and, if indicated, blood typing and cross matching.

Although most patients with epistaxis can be treated as outpatients, hospital admission and close observation should be considered for elderly patients and patients with posterior bleeding or coagulopathy. Admission also may be prudent for patients with complicating comorbid conditions such as coronary artery disease, severe hypertension, or significant anemia.

with regards- Dr Sanjay Kini




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How To Treat Nasal Bleeding In An Adolescent?

Hello. Nose bleed is called epistaxis in medical terms. If home remedies which you suggested doesnt work then you need to take him to doctor. I will tell you what measures are taken in hospitals. Initial management includes compression of the nostrils (application of direct pressure to the septal area) and plugging of the affected nostril with gauze or cotton that has been soaked in a topical decongestant. Direct pressure should be applied continuously for at least five minutes, and for up to 20 minutes. Tilting the head forward prevents blood from pooling in the posterior pharynx, thereby avoiding nausea and airway obstruction. Hemodynamic stability and airway patency should be confirmed. Fluid resuscitation should be initiated if volume depletion is suspected. Every attempt should be made to locate the source of bleeding that does not respond to simple compression and nasal plugging. The examination should be performed in a well-lighted room, with the patient seated and clothing protected by a sheet or gown. The physician should wear gloves and other appropriate protective equipment (e.g., surgical mask, safety glasses). A headlamp or head mirror and a nasal speculum should be used for optimal visualization. When posterior bleeding is suspected, the general location of the source should be determined. This step is important because different arteries supply the floor and roof of the posterior nasal cavity; therefore, selective ligation may be required Diffuse oozing, multiple bleeding sites, or recurrent bleeding may indicate a systemic process such as hypertension, anticoagulation, or coagulopathy. In such cases, a hematologic evaluation should be performed. Appropriate tests include a complete blood count, anticoagulant levels, a prothrombin time, a partial thromboplastin time, a platelet count and, if indicated, blood typing and cross matching. Although most patients with epistaxis can be treated as outpatients, hospital admission and close observation should be considered for elderly patients and patients with posterior bleeding or coagulopathy. Admission also may be prudent for patients with complicating comorbid conditions such as coronary artery disease, severe hypertension, or significant anemia. with regards- Dr Sanjay Kini