One evening at about 11 pm, a patient called me, frantically explaining that she was bleeding to death from a nosebleed. She tried everything her family had suggested to stop the oozing blood, including holding her head backwards, forward and even sideways. She had placed ice cubes across the bridge of her nose and also across the back of her neck, but to no avail.
Her family was in a state of panic. Her husband demanded that she go to the emergency room, but she wanted my help. Because of the strained and panicked voices over the phone, I jumped into my car and made yet another house call.
When I walked into her house, it was evident that everyone was in a state of panic and confusion, even the cat. Mom was bleeding to death, and the blood-soaked washcloth she held to her nose was doing no good. She must have lost at least a tablespoon of blood, and I know that she had never donated a pint of it in her life. Immediately, to get law and order from her family, I assured them that I had never witnessed anyone dying from a nosebleed. I didn’t have the heart to tell them, however, that it could happen and the emergency room would have been the best place to get assistance.
Examination revealed that her vital signs were stable and blood was slowly oozing from her left nostril. After calm was restored, I put on latex gloves (AIDS prevention), took a strip of pliable gauze and with a tweezer began to pack very firmly the left nostril. This was easily done by placing the gauze at the entrance of the nostril and pushing it back firmly in a folding, pleating fashion. Any clean strip of a hankie or sheet could be used.
The septum divides the right and left side of the nose. The network of blood vessels found on the septum is known as the Kiesselbach plexus, named after Dr. William Kiesselbach. This network of blood vessels, which helps to warm the incoming air, can bleed easily if picked or injured when blowing one’s nose too hard. The septum of the nose is also irreversibly injured if one chooses to snort cocaine. The damage done by this addictive habit causes a breakdown in the lining that leads to a hole in the septum. Beware y’all who choose to snort cocaine. It can destroy a beautiful God-given structure.
While packing the nose with gauze, my patient was instructed to calmly breath through her mouth. After adequate packing, the nose was pressed firmly together for two minutes and then released. After several of these maneuvers, the nosebleed ceased and the packing was removed.
Everyone smiled, including the cat, which was now resting on the patient’s lap, calmly being petted. Her husband was relieved, since he knew that he would not be up all night in the emergency room. I was relieved because I could return home and get some shuteye.
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