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Epistaxis (nosebleeds) have different causes. Most frequently, blood comes from kiesselbach’s part, which is located in the nasal septum’s front area and contains many blood vessels. Generally, bleeding may be controlled by pinching nose’s sides together for five to ten minutes. If such method does not stop the bleeding, a physician looks for bleeding source. Nosebleeds may be stopped for a while by applying pressure inside the person’s nose with a cotton wool piece saturated with a cotton wool piece saturated with a medication that causes blood vessel to constrict, including phenylephrine and with local anesthetic, including lidocaine. After the nose bleeding is stopped and the site has numbed, the doctor is cauterizing, the source of the bleeding with electrocautery (electric current, producing heat) or silver nitrate. If the epistaxis is caused by a disorder, the source of the bleeding is not sealed because it can start to bleed again. In this situation, a doctor is gently pressing gauze impregnated with Vaseline (petroleum jelly) against the source of bleeding. After stopping of bleeding, a doctor tries to determine a correct the causing disorder. In individuals with high blood pressure and arteriosclerosis (narrowing of the arteries), the source of the bleeding may be further in the nose, where stopping of the bleeding is more difficult. In some cases, a doctor should ligate (close off) the arteries, which supply blood to the part or pack nasal cavity back with gauzes. Generally, such packing is left in place for four days, and ampicillin (antibiotic) is prescribed orally to prevent middle ear or sinuses infection. Individuals with hereditary hemorrhagic telangiectasia can have severe nosebleeds, causing persistent, severe anemia that is very difficult to correct with iron. A graft of skin into the nasal septum is reducing nosebleeds number, so that the anemia may be corrected. Individuals with extensive liver disease, which may cause tendency to bleed, frequently have serious nosebleeds (epistaxis). Large blood amounts can be swallowed and broken down onto ammonia by intestine bacteria. Ammonia may be absorbed into the blood and may cause the people to become comatose or stick, so cathartics and enemas are given for the blood removal from the person’s intestine promptly. Additionally, such antibiotics as neomycin is prescribed to prevent blood breakdown into ammonia. Blood transfusion can be given, if large amounts are lost.
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