HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 14-25
Emergency: Nosebleed (Epistaxis) __RN
PURPOSE:
To control bleeding and prevent hemorrhage.
CONSIDERATIONS:
1. Nosebleed may indicate an underlying disease, e.g.,
hypertension, a blood dyscrasia, anticoagulant
therapy, coronary artery disease, alcoholism, or
recent upper respiratory tract infection.
2. Most nosebleeds stop when direct pressure is
applied.
3. Assess for symptoms of hypovolemic shock caused
by severe blood loss.
4. Check for Medic-Alert bracelet, which may indicate
that patient has a blood dyscrasia.
5. A patient with a nosebleed should remain quiet,
sitting up and leaning slightly forward. If it is
necessary to lie down, the head and shoulders
should be elevated.
EQUIPMENT:
4 x 4 gauze pads (optional)
Cold compress or ice pack (optional)
Gloves – if available
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure to patient.
3. Place patient in a seated position with head slightly
forward.
4. Have patient pinch the nostrils together for a
minimum of ten (10) minutes using a 4 x 4 gauze
pad if desired. (The nurse may have to do this for
the patient.)
5. An ice pack may be applied to the bridge of the
nose.
6. Obtain medical history and current medications.
7. Take vital signs and observe patient's general
condition.
8. Contact the physician if bleeding is not controlled or
transfer to ER.
9. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Severity and duration of bleeding.
b. Treatment provided.
c. Patient's response to treatment.
2. Contact physician to report incident and obtain
further orders.
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