Nosebleeds Treatment
Posted by admin on October 19th, 2009
When a nosebleed occurs, in providing emergency treatment, cessation of the bleeding is aided by the maintenance of an elevated position of the trunk and by promoting vasoconstriction in the nasal mucous membrane. The patient should refrain from talking and breathe through his mouth. The patient should also compress the soft outer portion of the nose against the midline septum for five to ten minutes continuously. The installation of a local vasoconstricting drug, such as Neo-Synephrine, into the nostril may be helpful.
Should these measures fail, the physician attending to the patient may find it necessary to apply Adrenalin or a cauterizing agent, such as silver nitrate solution or stick, to the bleeding point. Often times, the origin of the bleeding cannot be found. In theses cases, after spraying the patient’s nose with cocaine and Adrenalin solutions, a rubber finger cot or the finger of a rubber glove may be inserted into the nostril, the open end being held with three or four hemostats while a gauze packing is inserted. Pressure may be increased by moistening the gauze. The gauze packing should be removed after twenty-four hours.
The treatment of nasal obstruction requires the removal of the nasal obstruction, followed by measures to overcome whatever chronic infection exists. In most patients, the underlying nasal allergy is the legion which requires the treatment. At times it is necessary to drain the nasal sinuses by extreme operation. The operation performed depends on the type of nasal obstruction found. They are usually performed using local anesthesia.
If a deflection of the septum is the cause of the obstruction, then, an operation commonly called a submucous secretion is performed. The surgeon makes an incision in the mucous membrane and after raising it from the bone, removes the deflected bone and cartilage, using bone forceps. The mucous is then allowed to fall back in place and is held there by tight packing. This packing is usually soaked in liquid petrolatum to facilitate the removal in twenty four to thirty six hours.
Nasal polyps are removed by clipping them at their base with a wire snare. Hypertrophied turbinates may be treated by stringent application to shrink them up close to the side of the nose. After these procedures, the head of the bed is elevated to promote drainage and alleviate discomfort due to edema. Frequent oral hygiene should be given because the patient breathes through his mouth.
As a general rule, bleeding can be controlled by the application of cold compresses. It is helpful to use a roentgenogram to determine the displacement of the fractured bones and to rule out an extension of the fracture into the skull. With local cocainization of the nose or intravenous anesthesia, it is possible to bring displaced fragments into alignment and then hold them by intranasal packing or external splints. The important points in the reduction of the fracture are to reform the nasal passages and to realign the bones in order to prevent disfiguring deformity. After reduction, the swelling that occurs may be decreased by the application of ice compresses while the patient is in a sitting position.
Tags: nasal obstruction, nasal polyps, nosebleed