Spire Clare Park Hospital Crondall Lane Crondall Farnham GU10 5XX T 01252 852552 F 01252 851331
E infosurrey@entpartnership.co.uk www.entpartnership.co.uk
Jonathan Hern FRCS (ORL).
Appointed to Frimley Park Hospital in 2003. Special interest in rhinologyincluding rhinoplasty surgery and also voice problems.
David Jonathan FRCS.
Appointed to Frimley Park Hospital in 1991. Special interest in earsurgery, including implantable hearing aids. Involved in the regionaltraining of ENT surgeons.
Andrew McCombe MD FRCS (ORL).
Appointed to Frimley Park Hospital in 1995. Special interest in headand neck surgery. Involved in the management of NHS services.
Special interest in medicolegal work.
Epistaxis can be a significant health risk and prompt and effective treatment is essential. Please feel free to phone Ward F12A for furtheradvice regarding this common problem.
Epistaxis is bleeding from the nose. Sometimes the blood runs into the back of the throat from the nose.
In young people the bleeding is usually from the front part of the nasal septum, the partition inside the nose.
The Surrey & Hampshire ENT Partnership In older people, the bleeding can occur from further back inside the nose.
A nose bleed can occur spontaneously or there are certain specific British Association of Otorhinolaryngologists • Nasal infections, such as the common cold • Blood clotting abnormalities, including medication, • Abnormalities in blood vessels themselves Most nose bleeds can be stopped by simple first aid measures.
The majority of nose bleeds respond to either chemical or electric Whilst sitting up, apply pressure to the front of the nose by gently cautery or nasal packing within 24 hours. If the nose continues to squeezing the tip of the nose between the thumb and forefinger for bleed, then the patient is taken to the operating theatre and the nose around 5 minutes. Cold compresses around the nose and face may examined under a general anaesthetic. If a bleeding point is identified, also help. If you feel faint, lie down with the bleeding side of your this can be cauterised. If the nasal septum is very bent inside the nose, nose uppermost. If a nose bleed continues for more than 30 minutes, then it is advisable to seek medical attention.
On occasion, it is necessary to clip a small vessel in the back of the If the bleeding is from the front of the nose, the bleeding point can be nose, which is the main arterial supply to the nose. Very rarely, both cauterised with silver nitrate, or an electric current, under local anaesthetic.
of these vessels are clipped and in addition vessels entering the nose from the eye may also be clipped. In the majority of cases, these If the bleeding is from further back in the nose, it is often possible to measures are successful, but extremely rarely it is necessary for further visualise the bleeding vessel with an endoscope, which enables cautery.
surgery to stop the bleeding, which may include the ligation of an artery In certain instances, when a bleeding point cannot be identified, or the bleeding is too profuse, the nose has to be packed with either a spongeor gauze impregnated with an iodine containing material.
On occasion, if the bleeding is from the back of the nose, a catheter is inserted into the back of the nose via the nostril and the balloon inflatedwith water. In addition, the front of the nose may also be packed.
Following a significant nose bleed, it is advisable to do the following: The nose may sometimes need packing on more than one occasion.
If packs are placed in the nose, admission to hospital is advisable.
It may be advisable to stop Aspirin or Warfarin medication for a while:this is usually done in consultation with a physician.
For minor nose bleeds, an antiseptic cream placed into the nose for • Avoid straining when going to the toilet

Source: http://www.entpartnership.co.uk/PatientInfo/Booklets/O003NoseBleedsEpistaxis.pdf

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