Epistaxis (Nosebleed)

                  Epistaxis, or bleeding from the nose, is a common complaint. It is rarely life threatening but may cause significant concern, especially among parents of small children. Most nosebleeds are benign, self-limiting, and spontaneous, but some can be recurrent. Many uncommon causes are also noted.

Types
1. Anterior bleeds and
2. Posterior bleeds

Causes 
✎ Most nosebleeds do not have an easily identifiable cause.
✎ trauma
✎ exposure to warm, dry air for prolonged periods of time,
✎ nasal and sinus infections,
✎ allergic rhinitis,
✎ nasal foreign body (object stuck in the nose),
✎ vigorous nose blowing,
✎ nasal surgery,
✎ deviated or perforated nasal septum

Symptoms 
- Bleeding : usually occurs from only one nostril.
- dizziness,
- weakness,
- confusion, and
- fainting.

Medical Treatment 
1. Anterior nosebleed :
✍ A minor nosebleed that has stopped may require no treatment at all. Frequently, the body will form a clot at the site of the bleeding that stops any further bleeding.
2. If the source of the bleeding is from a blood vessel that is easily seen, a health care practitioner may cauterize it (seal the blood vessel) with a chemical called silver nitrate after applying a local topical anesthetic inside the nose. Chemical cauterization is most effective when the visible bleeding originates from the very front part of the nose.
✍ In more complicated cases, a nasal packing may be required to stop the bleeding. Nasal packings apply direct pressure inside the nostril to promote clotting and stop the bleeding. Many different types of nasal packings are available, including petroleum (Vaseline) gauze, balloon nasal packs, and synthetic sponge packs that expand when moistened. The decision as to which one to use is made by the health care practitioner.
✍ Most people who receive an anterior nasal packing go home with it in place. Because these packings block the drainage pathways of the sinuses, antibiotics may be started to prevent a sinus infection. The packing is usually left in place for 48 to 72 hours.

2. Posterior nosebleed :
✍ A posterior nosebleed that does not stop bleeding on its own requires admission to the hospital, as these types of nosebleeds can be very serious. In order to control the bleeding, a posterior nasal packing will be inserted by your health care practitioner. While different types of packings are available, a balloon nasal pack is most commonly used.
✍ Unlike anterior nasal packings, posterior nasal packings are much more uncomfortable and frequently require sedatives and pain medications. Furthermore, potential complications such as infection and blockage of the breathing passages may be encountered with posterior nasal packings. Consequently, admission to the hospital, close monitoring and consultation with an otolaryngologist are required.
✍ Posterior packings are usually left in place for 48 to 72 hours. If this does not control the bleeding, arterial embolization or certain surgical procedures may be required.

Prevention 
1. Most nosebleeds occur during the winter in cold, dry climates. If a person is prone to nosebleeds, use a humidifier in the home. Petroleum jelly (Vaseline), antibiotic ointment, or a saline nasal spray also may be used to keep the nasal passages moist.
2. Try not to pick or blow the nose too vigorously.
3. If the nosebleed is related to an underlying medical condition (for example, liver disease or a chronic sinus condition), follow the health care practitioner's instructions to keep these medical problems under control.

[ Source : http://www.emedicinehealth.com ]