Nosebleed is a common problem, occurring in up to 60% of the general population and is often because of a respiratory illness or dry conditions. Nasal drying is common in the hot summer months because of the extreme temperature and dry air due to use of air conditioners. Here are some typical reasons for nosebleeds: • Nasal allergies • Blowing your nose too hard or trying to remove something from inside the nose • A result of “popping” the ear • Nasal exposure to chemicals • Frequent sneezing or having an upper respiratory infection • Use of nasal spray or a blood-thinning drug, such as aspirin • Inhaling air that is extremely dry or cold • Having recent surgery on the nose or elsewhere on the face • Breaking the nose or a similar injury • Uncontrolled blood pressure Bleeding can be controlled by direct pressure i.e. compression of the nostrils rasping the alae distally so all mucosal surfaces are opposed. Direct pressure should be applied continuously for at least five minutes, and for up to 20 minutes. The patient should be encouraged not to check for active bleeding. Patients who are properly instructed may control their bleeding while the evaluation gets underway. Other maneuvers include bending forward at the waist while sitting up (to avoid swallowing blood), placing a plug of cotton wool or gauze into the bleeding nostril (sometimes coated with antibiotic ointment), expectorating out blood that accumulates in the pharynx and a cold compress applied to the bridge of the nose. These maneuvers also should be taught to high-risk patients for use at home. Many ENT specialists recommend initial treatment with two puffs of oxymetazoline to hasten hemostasis.

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