Bleeding Nose Or Epistaxis (Nosebleed)

Definition
Epistaxis or nose bleeding reportedly occur in 60% of the general population. The peak incidence of epistaxis obtained in the form of two peaks (bimodal) at age <10> 50 years.
Epistaksia nose is bleeding that can occur due to local causes or common causes (systemic disorders). Epistaxis is not a disease, but a symptom of a disorder.

Anatomy And Physiology Nose
The nose consists of outer nose or nasal pyramid and nasal cavity. Nasal pyramid consists of:
1. bridge of the nose (bridge)
2. dorsum nasi (dorsum = back)

3. nasal peak
4. ala nasi (Alae = wing)
The function of the nose is to:
1. airway
2. regulator air conditions (temperature and humidity set)
3. air filter
4. the sense of smelling (olfactory)
5. for air resonance
6. assist the process of talking
7. nasal reflex
Epistaxis is divided into two, namely the anterior (front) and posterior (back). Anterior epistaxis cases mainly from the front of the nose to the origin of the hemorrhage is kiesselbach plexus. Generally comes from Epistaxis posterior nasal cavity through the posterior branch a.sfenopalatina.
Anterior Epistaxis obvious clinical symptoms such as bleeding from the nostrils. Posterior epistaxis often show symptoms that are not too clear as nausea, vomiting blood, coughing up blood, anemia and posterior epistaxis usually involve large blood vessels so that more severe bleeding. Epistaxis (nosebleeds) in children generally come from little's area / kiesselbach plexus located on the front wall of the nasal septum.

Classification
Nosebleed Front (Anterior)
If the wound is blood vessels in the nasal cavity the front, it is called 'bleed front' (= anterior epistaxis). More than 90% of this type of bleeding is bleeding. Nosebleed forward more often about the children, because at this age selapun nasal mucus and blood vessels has not been too strong.
Nosebleeds usually marked by the release of future blood through the nostrils, either through one or both nostrils. Rarely bleeding out through the back of the head to the throat, unless the victim on his back or looked up.
On examination of the nose, can be found bleeding source location. Usually in the nasal septum, but sometimes also on the side wall of the nasal cavity.
Anterior nosebleeds due to:
1. Prying nose
2. Prolonged inhalation of air dried, for example at altitude or air-conditioned room
3. Prolonged exposure to sunlight
4. Colds or sinusitis
5. Blowing your nose too strong
Usually relatively harmless. Bleeding arising lightweight and can stop itself in 3-5 minutes, although it is sometimes necessary actions such as pressing and nose with a cold compress.
Some steps to tackle next nosebleed:
1. The patient sits in a chair or stand, head bowed slightly forward. In the sitting or standing position, a bloody nose higher than the heart. This action is useful to reduce the rate of bleeding. Head inclined forward so that blood flow through the nostrils, do not fall into the throat, which, when entered into the stomach causing nausea and vomiting, and if it enters into the lungs can cause respiratory failure and death.
2. Press around the nostrils, just above the nostrils and under the nose. Keep this act for 10 minutes. Try not stop pressing until the 10 minutes has elapsed. Patients were asked to breathe through the mouth.
3. Give cold compress on the area around the nose. Cold compresses blood vessels to help wrinkles, so bleeding is reduced.
4. After the bleeding stopped, should not be digging the nose and exhale through your nose too strong should be at least within 3 hours.
5. If the first treatment does not work, the victim should be taken to the hospital, because it may take the tent (rolled gauze) into the nasal cavity or the act of cauterization. During the trip, the patient should remain seated with bow slightly forward position.
2. Rear nosebleed
Nosebleed back (= posterior epistaxis) occurred due to injury to the blood vessels of the nasal cavity rear. Nosebleed rear rare, but relatively harmless. Nosebleed behind most of the adults, although it did not rule out also the children.
Behind the bleeding is usually more severe because the injury was suffered considerable blood vessels. Being situated at the back, the blood tends to fall into the throat and then swallowed into the stomach, causing nausea and vomiting of blood. In some cases, there was no blood coming out through the nostrils.
Some causes of nosebleeds behind:
1. Hypertension
2. Scarlet fever
3. Nasal or nasopharyngeal malignant tumors
4. Blood diseases such as leukemia, hemophilia, thalassemia, etc..
5. Lack of vitamin C and K.
6. Etc.
Behind the bleeding is more difficult to overcome. Therefore, the patient should be immediately taken to a clinic or hospital. Usually medics do the tent behind. How, a catheter is inserted through the nostril through the rear cavity mouth (pharynx), then pulled out through the mouth. In the end it comes out through the mouth and gauze mounted balloon. Only the tip of the catheter was pulled nostril, then the gauze and the balloon became interested and clog up the back of the nasal cavity. It is expected the bleeding stops. If this action fails, the medical officer would probably do the cauterization. Another step you might consider is surgery to find blood vessels cause bleeding and then tied. This action is called ligation.