Short Sharp Scratch
Video Duration: 13 minutes
Haemorrhage from vessels in the nose, can be anterior or posterior. Anterior is more common.
Bleeding commonly from Kiesselbach's plexus.
Usually idiopathic or trauma. Hypertension and anti-coagulation may predispose.
Rare causes include; Wegener's, bleeding disorders, tumours and Osler-Weber-Rendu syndrome (aka. Hereditary haemorrhagic telengiectasia).
Trauma / Foriegn Body
Symptoms of aspiration (coughing) suggest posterior bleed.
Clean and examine with nasal speculum,
Where is the bleeding? Unilateral, bilateral?
Full blood count, clotting screen, group and save (if severe or known coagulation defect)
Not usually indicated.
Most resolve with conservative management.
Pinch/pressure on soft part of nose. Tilt head forward. Ice pack on nose bridge.
If bleeding doesn't stop or if suspected posterior bleed, call ENT for posterior packing by insertion of a Foley Catheter.
Refractory bleeding may require artery ligation or embolisation.