a. Causes of Epistaxis. A nosebleed can be caused by a blow to the face or
head (possible skull fracture), infection such as sinusitis, high blood pressure, digital
trauma to the nasal airway, and certain diseases.
b. Treating Epistaxis. A nosebleed can be controlled using the following
(1) Position the casualty in a sitting position with his head tilted forward.
This position helps the blood to drain through the nose rather than entering the throat.
(2) Apply pressure to the nostrils. Pressure can be applied by pinching the
nostrils together. Pressure can also be applied by placing a rolled piece of gauze
bandage between the upper lip and gum; then pressing the bandage against the nasal
region with the fingers.
(3) Apply an ice pack or ice wrapped in material to the nose. The local
cooling will help to control the bleeding.
(4) Keep the casualty calm and quiet. Anxiety may cause an increase in
blood pressure that may cause an increase in bleeding.
c. Monitoring the Casualty. If bleeding cannot be stopped or if the bleeding
reoccurs, a more serious injury (such as posterior pharyngeal bleeding) may be
present. Evacuate the casualty to a medical treatment facility. Treat the casualty for
hypovolemic shock if needed and provide oxygen if available.