Postoperative Instructions For Nosebleeds (Epistaxis)

Nosebleeds, or epistaxis, are very common and are due to a number of causes. Injury or irritation to the inner lining of the nose from dry air, a “cold”, nose picking, or a blow to the nose are frequent reasons. High blood pressure may increase the likelihood of nosebleeds, although the
bleeding itself may elevate a normal blood pressure, which may contribute to the problem. Blood thinning medications, like Coumadin, aspirin, or aspirin products may cause easy bleeding from the nose or other locations.

Most nosebleeds are from blood vessels along the septum (middle) of the front part of the nose, and are usually easily controlled. Bleeding from the back part of the nose is much more difficult to control and often results in bleeding from both sides. Treatment consists of removing the clots, using various anesthetic and blood vessel-constricting medications, cautery, packings, or removal of any causative factors.

Do not pick, rub, or blow your nose after your nosebleed has been controlled. Also, avoid smoking, aspirin, and any other contributing factors discussed with your doctor. Do not do any heavy lifting or bending for four to five (4-5) days. Cough and sneeze through your mouth for four to five (4-5) days. Moisturizing your nose with salt-water nasal sprays and polysporin is helpful in decreasing the chance of a recurrent nosebleed. This should start the day after your nosebleed is treated and should be done twice a day. If bleeding recurs; sitting upright, place a piece of cotton soaked with Afrin (over the counter) nasal spray in the nose prior to pinching to help with constricting the bleeding vessel and assist in stopping the bleeding, then sit up straight, pinch your nose firmly and continuously hold it for fifteen (15) minutes. DO NOT let go every few minutes, or the bleeding will recur. Leaning forward slightly from the waist will help avoid bleeding down the back of your throat. Try not to swallow blood that runs down the back of your throat, as it may make you sick to your stomach. Avoid the head down position, and avoid very hot or cold foods.

If a pack has been placed, it is usually removed in three (3) days. Take any medications prescribed exactly as directed, unless problems develop. If any vomiting or trouble breathing occurs, you should notify your doctor immediately. If severe symptoms develop, go directly to the emergency room. If you are doing well, plan to follow-up as directed by your doctor. Please call the office if you have any other questions at (772) 398-9911, (772) 464-6055, (863) 357-7791 or contact the Answering Service after hours by dialing (772) 320-0400.

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