”oh my god, why my nose is bleeding??”

EPISTAXIS is not a disease but a symptom. It is presented by internal bleeding from the nose.



  • Trauma due to nails,
  • Any injury,
  • Hereditary,
  • Infections


  • Cardiovascular causes,
  • Blood clotting problems,
  • Kidney diseases,
  • Liver diseases,


That is a cause is unknown.


Two types. 1. Anterior epistaxis i.e. from the anterior part of the nose.

  1. Posterior epistaxis i.e. from the posterior part of the nose.

The most common region of epistaxis is little’s area.

Arterial supply of nasal septum:-

Arterial supply of lateral wall of nose:-


  • First aid– it is the most practiced treatment and easily available. Pinch the nose by thumb and index finger for few minutes. Trotter’s method is lying against the sink and through blood from the mouth if bleeding is from the posterior region.
  • Anterior packing– as the name suggests it is for anterior epistaxis. In this, a gauze piece soaked in paraffin and pack the nose either from floor to roof or back to front.
  • Posterior packing– it is for posterior epistaxis. In this, a gauze piece is taken and 3 threads are tied. Then a catheter tube is taken to which gauze piece and threads are tied. The catheter tube is inserted through the mouth but taken out through the nose so that gauze piece is placed at the back of the nose.
  • Endoscopic catheterization– in this, endoscopically catheter is inserted with gauze piece.
  • Ligation of vessels-

Vessels which can be ligated can be-

  1. Maxillary artery
  2. Ethmoidal artery
  3. Internal or External carotid artery

The new technique is TESPAL in which sphenopalatine artery is ligated instead of a maxillary artery.

Care after surgery:-

  • Check B.P., PULSE, R.R., TEMP.
  • For diet, do as doctor says,
  • If any anxiety gives anti-anxiety medicines.

Remember, don’t panic while treating it. Be calm and cool…

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