Nosebleeds can be a frightening event for most people, especially seniors. One out of every seven Americans will develop a nosebleed at some time, mostly during winter months and in dry, frigid climates. Most commonly effected are youngsters, 2-10 years old, and adults 50-80 years of age. Early morning hours are when most nosebleeds occur.
Types of Nosebleeds
There are two types of nosebleeds - anterior and posterior. Anterior nosebleeds are the most common, effecting 90% of most patients and are easily controlled. Posterior nosebleeds occur far less often and usually involve elderly people. Originating from an artery in the back of the nose, these nosebleeds are more problematic, more severe and may require a hospital admission and review by an otolaryngologist (ear, nose, and throat specialist) for adequate management.
The cause of most nosebleeds is not easily identified. For the most part, trauma to the nose is the culprit. However, in seniors, an underlying condition may be at play. The inability of the blood to clot may be caused by blood-thinning medications such as warfarin or aspirin. Liver disease can also prevent sufficient clotting. Abnormal blood vessels or cancer of the nose are rare causes and hypertension may be a contributing factor, but usually is not the primary reason for the nosebleed.
Nosebleeds usually only occur from one nostril. If heavy, blood can fill up the affected nostril and flow into the nasopharynx (the internal area where the nostrils converge), cause bleeding from both nostrils. The blood can also drip down the throat or to the stomach, causing spitting or vomiting blood.
If unchecked, excessive blood loss may lead to dizziness, confusion or fainting. Fortunately, this situation rarely occurs. Simultaneous bleeding from other parts of the body, or bruising, may be an indication of a serious medical problem that requires immediate attention.
When to Go to the Emergency Room
There are occasions when a nosebleed requires an immediate visit to the hospital. If bleeding is still present after pinching the nose for 10 minutes or more; numerous nosebleeds over a short time period; dizziness or fainting; rapid heartbeat; difficulty in breathing; spitting or vomiting blood; the presence of a rash or temperature over 101F degrees - the patient should be taken to the nearest hospital emergency room for examination.
Anterior, and specifically posterior nosebleeds, that do not respond to home treatment will require further medical attention. A posterior nosebleed that does not resolve itself will likely result in a hospital admission. A posterior nasal packing, usually a balloon pack, is the common treatment. Posterior nasal packings are understandably extremely uncomfortable and sedatives and pain medication are recommended. Infection and blockage of the breathing passages can complicate matters. The packings will be in place for two to three days. Although seldom needed, surgical procedures may be completed to stop the bleeding if the packings are not successful.
Nosebleeds can be startling and alarming for anyone, especially senior citizens. Being able to recognize the difference between a casual problem and a life-threatening condition, may ultimately be the key to saving your loved one's life.