Nosebleeds, or epistaxis, are a common issue among the elderly population, particularly those who are taking anticoagulants. As a caregiver in a nursing home, understanding how to prevent and manage these incidents is crucial for resident well-being to avoid a visit to the Emergency Department.
Prevention Strategies
- Humidification: Keep the air moist using humidified forced furnace air, if allowed, especially during winter months when indoor air tends to be drier.
- Nasal Care: Encourage residents to use saline sprays or gels to keep their nasal passages lubricated. A small amount of petroleum jelly applied gently inside the nostrils can also help.
- Gentle Handling: Remind residents to be gentle when blowing their nose and discourage nose picking, which can damage the sensitive blood vessels inside the nose.
First Aid for Nosebleeds
- Stay Calm: Reassure the resident and help them to stay calm. Anxiety can increase blood pressure, potentially worsening the nosebleed.
- Positioning: Have the resident sit up straight and lean slightly forward. This prevents blood from flowing down the throat, which can lead to coughing or vomiting.
- Nasal spray: You can apply 3 sprays of decongestant (oxymetazoline) in the affected side.
- Pinching the Nose: Pinch the soft part of the nose just below the bony bridge, holding it firmly for 5 to 10 minutes. This applies pressure to the bleeding point on the nasal septum and often stops the flow of blood.
- Cold Compress: Apply a cold compress or ice wrapped in a towel to the bridge of the nose. This can constrict the blood vessels and reduce bleeding.
When to Seek Medical Attention
While most nosebleeds can be treated effectively at the nursing home, there are situations where medical attention is necessary:
- If the bleeding is severe or does not stop after 30 minutes of direct pressure.
- If the resident is having other symptoms such as elevated blood pressure, lightheadedness, chest pain, or rapid heart rate.
- If the nosebleed is the result of a fall or injury to the head.
By following these preventative measures and treatment protocols, nursing home staff can effectively manage nosebleeds in residents, ensuring their comfort and safety. Remember, while nosebleeds are common, they should be considered an adverse drug event if the resident is on blood thinners, so monitoring and documentation are key.
Toolkits & References:
- Michigan Anticoagulation Toolkit
- Michigan Anticoagulation Video
- Nosebleeds: Minor to serious – Mayo Clinic Health System
- Nosebleeds: First Aid – Mayo Clinic
- Anticoagulants (Blood Thinners): What They Do, Types and Side Effects – Cleveland Clinic
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