EPISTAXIS( NOSE BLEED) IN ELDERLY

Nose bleeding in an elderly patient can be due to various causes, some times it can occur without any reason too. A slight male preponderance seen with in  an age group of 60's.

Bleeding can be minor or major, some times from anterior ( front) and posterior ( back) of the nose. 

Weather( autumn and winter) cases are more. Uses of analgesics( NSAID) like aspirin can lead to nose bleed, along with alcohol ,bleeding will be more. High blood pressure has been noticed during bleeding in some cases. 

DNS( deviation of nasal septum )with spur  is another cause. Nose picking also can be a factor. Secondary causes can be liver disorder, blood disorders, sinusitis, angiomas, abnormalities of artery and veins, certain other noncancerous and cancerous tumours. 

When bleeding occurs don't panic, if it is mild oozing from the front part of the nose, pinch your nose for sometime( few seconds)  If it's not stopping, visit a doctor immediately .MAJOR BLEEDING warrants IMMEDIATE  HOSPITAL  VISIT. Patient can go in for shock or can aspirate the blood. 

Don't forcefully blow the nose, inform the doctor the amount of blood lost, in terms of tissues or towels used, duration of bleeding, any precipitating factor. Always inform  the doctor, what all medicines you are taking. History of heart  ailment should be informed. 

Frequently asked question, what should I do? swallow the blood or spit it out? 

ALWAYS SPIT THE BLOOD OUT, DON'T SWALLOW IT, AS IT CAN CAUSE IRRITATION OF STOMACH AND VOMITING. 

POSTERIOR BLEEDING MORE SERIOUS ( as source of bleeding may not be visible).