Talk:Nosebleed

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I am an Ear Nose and Throat Surgeon from the UK. I have updated the article inline with current medical opinion and best practice and addressed some anatomical and conceptual misconceptions, hopefully whilst keeping the article within the scope of the layman. Many of the suggested treatments were quite anecdotal. As Wikipedia may be a patients first port of call for advice I feel it best to include only medically approved first aid measures. If anyone has any techniques they use to control their regular nosebleeds perhaps they could add them in a further section. The picture is a little explicit but not inappropriate. Perhaps an anatomical diagram would also be useful. Please feel free to comment. DrProwse (talk) 19:31, 9 January 2008 (UTC)[reply]

I don't feel that the search "broken nose" should redirect to "nosebleed" it is possible after all to break your nose and not have it bleed. This redirection should be removed.

Feel free to use mine: http://www2.cs.uh.edu/~lbarchie/images/blood2.jpg i'm a chronic nosebleeder.

C'mon people... that picture is so gross.Ramsquire 22:55, 19 Nov 2004 (UTC)

You are empowered to provide a better one. Don't break your nose for it, though. JFW | T@lk 01:55, 21 Nov 2004 (UTC)

LOL!!! I am not sure this page needs a picture, but I'll look for one and post it here before I put it in the article.Ramsquire 17:46, 22 Nov 2004 (UTC)

I am not sure if this needs a picture either. But if you do I think the image should be cropped to not show the entire face. Joneboi 11:32, 21 November 2006 (UTC)[reply]

Ill consider making a side-cut diagram of the nose, pointing out the vulnerable bleeding area. Just don't expect it any time soon.--Dagibit 19:46, 30 January 2007 (UTC)[reply]

Please do not remove appropriate images from articles. Some of us may find certain things gross to look at, but if we all started weeding out the images that grossed us out we'd soon have no pictures of spiders, caterpillars, snakes, ichneumon wasp grubs and the like. --Tony Sidaway|Talk 19:35, 11 Feb 2005 (UTC)

As the original submitter of the photo, I don't think the photo is gross or superfluous. I think articles should include images where possible even if people know what the subject looks like; potato, say, or leg have images, though I suspect all users know what those objects look like. Rls 03:45, 2005 Feb 27 (UTC)

The photo has now been removed. In all frankness, it is not a photo of a nosebleed but one of a fractured nose. JFW | T@lk 08:33, 8 Mar 2005 (UTC)

The photo is of a nosebleed because of a fractured nose. It has been restored. Rls 17:23, 2005 Mar 8 (UTC)

It serves no purpose, anyone should know what a nose bleed looks like, its name sums it up pretty well. unsigned

Look, this is an article about nosebleeds. It is illustrated with a picture of a chap with a nosebleed. Please stop removing the picture. --Tony Sidaway|Talk 19:29, 14 Mar 2005 (UTC)

putting up a pic of a guy with a nosebleed is like putting up a picture of diarrhea on the diarrhea page. What's the point? we know what it looks like... Andrewr47 03:01, 9 April 2006 (UTC)[reply]

ABSOLUTELY A VALID POINT. Take this picture down or I will take a photo of the toilet and post it to diarrhea next time I have the runs. Shiggity (talk) 23:02, 28 January 2008 (UTC)[reply]

Ugh that picture is disgusting. We all KNOW what a nosebleed looks like

i was more grossed out by his smashed nose than the blood. Nose bleeds obviously happen if a nose gets smashed, i would assume most people think of nose bleeds with no real damage, like a random nosebleed, maybe the guys pic up top ^ would be better

There is a difference between having a picture of a potato and having a picture of some guy that may have a nose bleed.

It is encyclopedic to have a picture. Rls probably does not like being compared to a potato. Be a good boy and leave the picture there until you're able to upload something better. Please do not harm any fellow human beings in the process. JFW | T@lk 21:08, 14 Mar 2005 (UTC)

Are we being POV against rugby players by suggesting that getting whacked on the nose and having a nosebleed is normal in rugby? ;) BTW, AFAIK, women often (sometimes?) have nosebleeds due to pregnancy (which seems to be missing in the text content), so maybe we should have a photo of a pregnant woman with a nosebleed as well... (No, i don't have a photo.) But then there would be the association of violence in rugby and pregnancy - this could turn into a whole can of worms... Better pretend i didn't say anything. ;) Boud 23:46, 14 July 2005 (UTC)[reply]

I think the thing that's bugging us (well, not this last digressing chap:) is that it's the picture of a guy with a broken nose, which we all know has to hurt a lot(never mind this guy's smile for the camera), so that's why it's at least mildly uncomfortable to watch; anyone could easily put the picture of anyone nose bleeding from a painless ailment, which is more common (in real life, of course). I'd be thankful to anyone who did just that. Kreachure 22:44, 4 August 2005 (UTC)[reply]

If it helps at all, it didn't particularly hurt. Compared to, say, having it straightened back out anyway. Rls 13:06, August 15, 2005 (UTC)

Well, this picture grossed me out a lot. Maybe the picture should be added at the bottom of the article wtih a disclaimer before it. My first reaction to this article was gross because the picture is really gross, and I usually am able to tolerate things like this. People may not be able to read and learn from this article wtih this picture here. I wanted to remove it, and it seems like many other people also wanted to too. 06:17, 15 March 2006 (UTC)

When you request an article on nosebleeds you get to see a nosebleed. We don't censor for this purpose. JFW | T@lk 07:17, 15 March 2006 (UTC)[reply]

We can have the picture , just at the bottom. 19:37, 15 March 2006 (UTC)

When I originally objected to the photo, it was because of dude's broken nose. But it was mostly tongue in cheek. I think a photograph of a nosebleed is fine. Ramsquire 17:14, 5 October 2006 (UTC)[reply]

Come on, people. This picture is completely unnecessary.

We know what a nose looks like and there are several pictures at http://en.wikipedia.org/wiki/Nose We know what blood looks like and there are pictures at http://en.wikipedia.org/wiki/Blood

We don't need someone's disturbing macho vanity shot. Take it down or I will. Shiggity (talk) 22:59, 28 January 2008 (UTC)[reply]

Get over yourself. It's the same thing as having a picture of a penis in the penis article. Or having a picture of a man or a woman in their respective articles (you should see the controversy regarding pictures on their talk pages). Go ahead, try taking it down. I'll bet that'll go over like a lead balloon. 198.30.62.212 (talk) 03:36, 18 February 2008 (UTC)[reply]

If there is a better picture of a nosebleed, perhaps that can be added to the article. But I see no reason this photo should be removed. It is highly illustrative of the topic. The article is clearly improved by its presence. Bryan Hopping ^T 04:35, 18 February 2008 (UTC)[reply]

What is the proper chemical name of the acid (CCl₃COOH) used to chemically cauterise nosebleeds? JFW | T@lk 19:57, 13 Apr 2005 (UTC)

Trichloroethanoic acid Rls 20:14, 2005 Apr 13 (UTC)

In reply to the section above, I've had silver nitrate applied where the wound is, but it's acutely painfull! It's also to my understanding it can scar, thus promoting further nose bleeds.

Petroleum jelly is pretty nasty to smell (a good reason why I avoid it).

My best defense is to hit the shower (or the sink if I'm in public), and masassage the nostrils from the inside with water. It usually cauterizes in minutes, and recurrence is less frequent and mild (if at all). It usually lasts me some days to many weeks.

---

The above advice sounds very good, but from one who suffered from spontaneous nose bleeds for years (and now have them under control) I give the following advice (no I am not a doctor)

1. STAY AWAY from vitamin E, It promotes bleeding. 2. IN dry months, rinse the nose with saline. It is sold as a mist in drug stores. 3. To stop a nose bleed, apply cold water to the back of the neck, and gently to the face. 4. RELAX, think nice thoughts, try to lower your blood pressure.

• why does epistaxis redirect here and not the other way around.

• I have started using a dime in between my upper lip and gums, where the middle part of my nose is. I was told that adding pressure with the dime reduces the circulation to the nose and therefore allows the wound to clot quicker/with less blood. - User not logged in: kpwa_gok

• sticking a coin in your mouth is never a good idea. Coins carry hundreds of strands of bacteria, and you are in effect giving them a free ride into your body

• Ah! I was told that the twisting a paper towel or napkin "like a Doobee" and placing it between the upper lip and gums has the same effect, cutting off a blood vessel that travels from between the front teeth to the source of the nosebleed thus assisting in the clotting process. I... guess this has helped my recent bleeds. I have seen this in other places on the web, but can't seem to find any official verification. Any of you know of a good source for this? --Dagibit 15:07, 30 January 2007 (UTC)[reply]

• This method has no basis whatsoever in medical fact! The blood supply of the nose is largely from the ethmoidal, palatal and spenopalatine vessels, none of which run under the lip or over the teeth! If you want to stop a nose bleed the only vessels you can compress are those on the nasal septum by pinching the fleshy part of your nose. Besides a coin is the last thing I'd want in my mouth! DrProwse (talk) 22:15, 9 January 2008 (UTC)[reply]

This looks like a good ref. for refractory bleeds --

Jackson KR, Jackson RT. Factors associated with active, refractory epistaxis. Arch Otolaryngol Head Neck Surg. 1988 Aug;114(8):862-5. PMID 3390329

It's one that thought to be included when the article is cleaned-up. Nephron  T|C 23:35, 14 May 2006 (UTC)[reply]

Ref "undecided as to whether...to tilt the head forward during this procedure ...or backward" IT IS EXTREMELY DANGEROUS TO TILT YOUR HEAD BACKWARDS WHEN HAVING A NOSE BLEED! I have experienced problems with nose bleeds all my life, and discussed it with numerous GPs, surgeons and other medics, none have ever recommended doing this; due to the extreme danger of the blood running into the lungs. Also if enough blood runs into your stomach it can make you very ill. You should always tilt your head forward and use one of the recommended methods to staunch the flow.

Ref Coin method above : The artery supplying blood to the nose & front of your face does run above your top teeth and you can use the long side of your finger to apply pressure to the gums under your top lip to control a nose bleed, but this should only be done in severe cases. Also no mention is made that a nose bleed can be related to trauma and injury to other parts of the skull/head. One last point - I have heard that the skin of grapes contain a substance which your body uses to build thicker vein walls, which could help (and eating a bit more fruit isn't going to hurt anyone is it!)

I have removed the following sentence "Medical opinion is divided on whether the best position to apply pressure is the bridge of the nose or the fleshy part. It is also undecided as to whether it is better to tilt the head forward during this procedure (to drain the blood and prevent it from flowing down the throat and into the stomach) or backward (to minimize the volume of blood in the nose)^{[citation needed]}. " as it is unsubstantiated and extremely dangerous. The whole treatment paragraph needs to be rewritten to make it clearer and less spurious. (Apologies if that sounds rude, but a lot of people do come to wikipedia as their first step for info, and bad info of this type could confuse and even harm somebody).

"Sometimes in more severe cases, the blood can come up the sinus and out from the eye." If you have a sinus connecting your eye, there's seriously something wrong with you. This sounds like someone thinks its the maxillary sinus. The only space normally connecting the orbital and nasal cavities is the nasolacrimal duct, which isn't a sinus. I can't see how blood could possibly go up through that either unless the anterior and posterior nares were blocked.--KX36 16:47, 28 January 2007 (UTC)[reply]

I suppose the blood could be wicked up the nasolacrimal duct. --BennyD 15:21, 30 January 2007 (UTC)[reply]

Haemolacria? Antelan ^talk 05:19, 20 August 2007 (UTC)[reply]

• Blood frequently tracks up the nasolacrimal duct when the nose is packed with an epistaxis dressing. DrProwse (talk) 22:17, 9 January 2008 (UTC)[reply]

Can dryness be a cause of nosebleeds? 74.112.49.141 02:16, 6 February 2007 (UTC)[reply]

I second that question. Anybody? --Nathanael Bar-Aur L. (talk) 16:03, 27 December 2007 (UTC)[reply]

I know that during the dry winter months I have regular nosebleeds, which almost completely stop during the humid summer months. Sleeping with a humidifier on seems to help keep the nosebleeds down too . . . --Stvfetterly (talk) 17:14, 9 January 2008 (UTC)[reply]

I would guess because dry skin is significantly easier to break? —Preceding unsigned comment added by Petitphoque (talk • contribs) 11:28, 30 April 2008 (UTC)[reply]

Removed "It is not recommended because the removal of the gauze will remove the clot. Eventually the body will stop clotting and the nasal passages will have to be cauterized. " from treatment section. Removal of the nasal packing does not remove the clot all the time and you say it is not recommended yet you site no source. Remember the no original research policy. Nasal packings are used in emergency rooms as well as commercial products available over the counter. Joneboi 23:19, 8 February 2007 (UTC)[reply]

Vitamin K is supposed to help the blood clot and thus prevent some nose bleeds. [1]--165.230.46.152 13:13, 22 March 2007 (UTC)[reply]

Does Telfast/fexofenadine cause nosebleeds?

I have added that an alternative to using petroleum jelly in the prevention of the dryness that can cause nosebleeds is by using, oddly enough, KY jelly. I've suffered three bad nosebleeds in the past two days and I stumbled upon this suggestion while researching treatment methods, so I figured I should amend the article to point this out. Tiado 19:39, 11 September 2007 (UTC)[reply]

Has anyone considered adding the fact that nosebleeds are often used in animated series to depict sexual perversion, particularly Japanese anime? —Preceding unsigned comment added by 76.106.216.224 (talk) 05:51, 29 December 2007 (UTC)[reply]

I've heard this too Scaeme (talk) 11:09, 16 May 2008 (UTC)[reply]

I was wondering about that too. I've never heard of anyone in real life have a nosebleed from being aroused, but it happens all the time in fiction. 99.129.211.60 (talk) —Preceding undated comment was added at 11:28, 25 December 2008 (UTC).[reply]

Hi, While I don't have a verifiable source, I don't believe in the practice of tilting the head forwards. From what I understand, the currently accepted practice is to keep the head in the neutral position. Until provided, i've added citation needed. Also, i _did_ read a primary scientific paper showing that ice does not have any beneficial effect. I'll be looking for the reference and will post it as soon as I find it. -- Woops... okay found it, here it is. http://www.ingentaconnect.com/content/bsc/cot/2003/00000028/00000006/art00013 I'm modifying the article, please correct me if i make any style errors. Comments? _James purpleidea (talk) 17:47, 30 January 2008 (UTC)[reply]

Tilting the head forward is best practice. It encourages any blood which flows into the oropharynx to track forward into the mouth rather than down onto the larynx or into the oesophagus. The paper you cite found no evidence that ice on the back of the neck slows nasal blood flow but the method is widely used in ENT departments and in my clinical experience can be effective

DrProwse (talk) 18:43, 5 February 2008 (UTC)[reply]

Health Illustrated Encyclopedia article: Nosebleed http://assets.aarp.org/external_sites/adam/html/1/003106.html

I want to thank the combined editors here for helping me stop a horrendous bleeding nose. It was a surprise gusher as I have never really had them before. Between the information here confirmed by the external link I was finally able to stop it after several hours. A trip to the hospital on a Saturday night was not going to happen. I finally packed with guaze and used ice bags to slow it down. —Preceding unsigned comment added by 71.139.48.11 (talk) 00:42, 12 January 2009 (UTC)[reply]

"(From the Wikpedia article Epistaxis .)" For some odd reasons the reference given is referencing this article. I think a better source is needed for that information. -su88 (talk) 07:39, 2 February 2009 (UTC)[reply]

I found a document with that information. For anyone who would like to verify, that pdf file is 3.6MB large; try to download it instead of opening it in a browser if your computer is slow. -su88 (talk) 08:33, 2 February 2009 (UTC)[reply]

In the list of possible local causes for epistaxis, "Intranasal tumours" is listed on the same level as "Inflammatory reaction" or "foreign bodies" without any kind of explanation.

I do not agree with this policy. It is certainly true that intranasal tumours may be the cause for epistaxis, but this is an extremely rare and unlikely cause when compared to nose-picking or inflammatory reactions. All this will achieve is to concern people bleeding from the nose (an extremely current condition) that they have cancer.

Would it be possible to mention somewhere that "intranasal tumours", "heart failure"..etc are very unlikely causes to epistaxis (although possible causes)?

Thanks, F.