When a patient with a nosebleed arrives at the hospital, the doctor’s primary goal is to control the bleeding. The approach varies depending on the severity of the bleeding. If the bleeding is minor, such as blood in nasal discharge, the doctor will focus on identifying the underlying cause, which could be related to local or systemic factors. In contrast, if the bleeding is substantial or the patient’s condition is critical, the doctor will prioritize stopping the bleeding to stabilize the patient before further investigation.

To determine the cause of the nosebleed, doctors examine both local and systemic factors. Local factors include various inflammations, such as rhinitis, sinusitis, or fungal sinusitis, which can weaken the nasal mucosa and lead to bleeding. Tumors are also significant local factors, including vascular tumors or nasopharyngeal fibrous vascular tumors in younger individuals, and malignant tumors in older adults. Additionally, trauma, such as a deviated septum, or foreign bodies in the nasal cavity, especially in young children, can cause bleeding by irritating the mucosa and leading to inflammation and mucosal damage.

Systemic factors include blood pressure abnormalities, which can cause nosebleeds due to ruptured blood vessels. Changes in coagulation mechanisms, such as blood clotting disorders, are also crucial. Liver or kidney dysfunction can affect blood coagulation, while nutritional deficiencies may weaken the nasal mucosa. Certain medications, particularly anticoagulants, can also cause nosebleeds.

To address the issue, doctors use various diagnostic methods. Local examinations commonly involve nasal endoscopy, which allows direct visualization of the nasal cavity to identify issues such as inflammation, foreign bodies, or tumors. If local examination does not reveal significant abnormalities, imaging studies like a sinus CT scan may be conducted to detect any sinus-related issues causing the bleeding. Additionally, systemic evaluations include measuring blood pressure, conducting complete blood counts and biochemical tests to assess platelet levels and coagulation mechanisms, and potentially performing ultrasound or other auxiliary tests to provide a comprehensive assessment of the patient’s health.

These diagnostic and evaluative methods help doctors understand the patient’s condition thoroughly, enabling them to develop effective treatment plans to control and resolve the nosebleed issue and restore the patient’s health.