Epistaxis

Nosebleed; bleeding from the nasal cavity

Definition

Epistaxis is bleeding from the nose, classified as anterior (90%, Kiesselbach's plexus) or posterior (10%, more severe, higher complication risk).

Common Causes

Trauma (nose picking, dry air, facial injury)
Hypertension
Anticoagulants and antiplatelet drugs
Cocaine use
Bleeding disorders
Septal deviation
Nasal tumors

First-Aid Interventions

Sit patient upright and lean FORWARD (not backward; prevents swallowing blood)
Apply firm pressure to the soft lower nose for 10 to 15 minutes
Breathe through the mouth
Cold compress to the nose bridge
Avoid blowing, picking, or inserting objects into nose

Severe Epistaxis

Cauterization, anterior packing, posterior balloon packing (requires admission due to risk of airway compromise), nasal endoscopy, or arterial embolization. Treat underlying hypertension or coagulopathy.

Nursing Considerations

Assess amount of blood loss, vital signs, and airway. Monitor for posterior bleeding if blood trickles down the throat. Humidify room air. Educate on saline sprays and avoidance of nose-picking.

NCLEX Relevance

Position: upright, lean forward. Do NOT lean back.