EPISTAKSIS

Epistaxis, also known as nosebleed, is the discharge of blood from the nose. Blood can come out of one or both nostrils with varying duration. Some last a few seconds, but some last more than 20 minutes.

Nosebleeds are a symptom that some people may experience. However, this condition is more commonly experienced by children aged 3-10 years, the elderly, pregnant women, people with blood disorders, and people taking blood-thinning drugs.

Reason

Causes of epistaxis can be local or systemic. Local causes are usually related to problems with the nose, paranasal sinuses and nasopharynx. Trauma is the most common cause of epistaxis, in children it is often caused by simple trauma, namely picking the nose. Systemic causes can be caused by cardiovascular disorders, hematological disorders and the use of anticoagulant drugs. Tumors also often cause epistaxis, especially in patients aged over 40 years.

CLASSIFICATION

Based on the location, epistaxis can be divided into two parts, namely:

    Anterior epistaxis

Often in children and usually stops on its own. Bleeding may originate from the Kiesselbach plexus (Little's area) or the anterior inferior turbinate.

    Posterior epistaxis

Posterior epistaxis can originate from the sphenopalatine artery and the posterior ethmoid artery. Bleeding is usually profuse and does not stop easily on its own. Often found in patients with hypertension, arteriosclerosis or other cardiovascular diseases.

 

PATIENT EDUCATION

    How to wash your nose the right way
    Avoid blowing your nose / sides loudly and not sneezing too hard
    If you sneeze, do it with your mouth open
    Don't manipulate or pick your nose
    Avoid using aspirin or other NSAIDs
    Avoid using corticosteroid nasal spray for a while
    If there is recurrent mild epistaxis (push like a rice 5-10 minutes), use an ice pack

PROGNOSIS

 With adequate management and addressing the cause, in general there is no recurrence. Several factors that play a role in recurrence are: age, history of hypertension, use of anticoagulants, previous history of severe epistaxis.

FOLLOW UP

The mean follow-up time after treatment of epistaxis was 7 weeks (2-19 weeks). Patients with hypertension should have regular check-ups with a cardiologist after discharge from the hospital.

If you have tried various ways to stop nosebleeds and have not succeeded, immediately consult a doctor or the nearest hospital emergency room. Especially if the nose has been pressed for more than 20 minutes and the blood has not stopped.