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Is nose bleeding in an elderly person a cause for concern?

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Posted on Tue, 10 May 2016
Question: My mother is currently in XXXXXXX Canada. Yesterday she had nose bleeding twice. She does not have a history of nose bleeding. Could you please advice?
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Answered by Dr. Mohammed Taher Ali (2 hours later)
Brief Answer:
She needs to be evaluated properly.

Detailed Answer:
Dear XXXXXXX Hi & Welcome.
Thanks for posting your query on healthcare magic.
I really appreciate your concern for your beloved mother who is currently living in Canada.
The nasal bleeding (epistaxis) is most commonly caused by local trauma such as nose blowing or picking, repeated irritation due to cold, blow to the face, drying of the nasal mucosa. Other less common causes include high BP, bleeding disorder, certain medications like 'blood thinners' (Aspirin, Clopidogrel, Warfarin or NSAIDs).

At home, her bleeding should be controlled immediately by compressing the nostrils. Direct pressure should be applied continuously for at least 5 minutes, and for up to 20 minutes. She can take breathing through mouth. Tilting the head forward prevents blood from pooling in the posterior pharynx, thereby avoiding nausea and airway obstruction. Then she needs to be examined by a doctor (preferably an ENT specialist) for further management.

If bleeding continues to occur, a cotton or gauze impregnated with a vasoconstrictor (Phenylephrine) and a topical anesthetic (Lidocaine) is inserted and the nose pinched for another 10 min.

If these methods are ineffective, she may need cauterization using silver nitrate after locating the actual site of bleeding.

Beside every effort should be made to find out the cause of bleeding and treated accordingly as outlined earlier. Usually lab tests are not required, however if the bleeding is severe or recurs she may need to undergo certain tests such as CBC, Coagulation profile, etc.

Hope the suggestions given above would be beneficial in controlling the bleeding from her nose.
Best wishes.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Mohammed Taher Ali

General & Family Physician

Practicing since :1988

Answered : 6134 Questions

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Is nose bleeding in an elderly person a cause for concern?

Brief Answer: She needs to be evaluated properly. Detailed Answer: Dear XXXXXXX Hi & Welcome. Thanks for posting your query on healthcare magic. I really appreciate your concern for your beloved mother who is currently living in Canada. The nasal bleeding (epistaxis) is most commonly caused by local trauma such as nose blowing or picking, repeated irritation due to cold, blow to the face, drying of the nasal mucosa. Other less common causes include high BP, bleeding disorder, certain medications like 'blood thinners' (Aspirin, Clopidogrel, Warfarin or NSAIDs). At home, her bleeding should be controlled immediately by compressing the nostrils. Direct pressure should be applied continuously for at least 5 minutes, and for up to 20 minutes. She can take breathing through mouth. Tilting the head forward prevents blood from pooling in the posterior pharynx, thereby avoiding nausea and airway obstruction. Then she needs to be examined by a doctor (preferably an ENT specialist) for further management. If bleeding continues to occur, a cotton or gauze impregnated with a vasoconstrictor (Phenylephrine) and a topical anesthetic (Lidocaine) is inserted and the nose pinched for another 10 min. If these methods are ineffective, she may need cauterization using silver nitrate after locating the actual site of bleeding. Beside every effort should be made to find out the cause of bleeding and treated accordingly as outlined earlier. Usually lab tests are not required, however if the bleeding is severe or recurs she may need to undergo certain tests such as CBC, Coagulation profile, etc. Hope the suggestions given above would be beneficial in controlling the bleeding from her nose. Best wishes.