Question: I recently had a nose bleed that lasted over an hour, but stopped just before I went to hospital. How should you stop a nose bleed?
The patient is placed in a sitting position (NOT lying down) and the soft part of the nose just beyond the end of the nose bone is squeezed together firmly. Ideally this should be done with a cloth soaked in icy water which will cause the blood vessels in the nose to contract. If excited, the patient is calmed down, and the nostrils are held firmly for 5 minutes without letting go. When the pressure is released, the bleeding should have stopped, and the patient can go quietly on their way.
If the bleeding continues, two more five-minute periods of compression should be tried. If these fail, medical assistance should be sought, as the bleeding may be coming from further back in the nose. The most common cause of bloody noses is drying out of the fine tissue on the nasal septum, which is covered with a network of veins designed to warm the air. If the tissue dries out too much it will split and bleeding occurs. Antiseptic and moisturizing creams can be used regularly on the septum inside the nose to prevent this drying in hot weather.
Question: With three children between six and thirteen, I am always dealing with their injuries. How should you treat a bad cut, and how can you decide when a cut should be seen by a doctor or stitched?
There are three essentials in dealing with any cut. The first is to stop bleeding, the second to prevent infection, and the third to repair the wound.
No matter how large the wound, the best way to stop bleeding is to apply pressure directly over the injury. Tourniquets should not be used. A piece of clean cloth several layers thick (for example a clean, folded handkerchief) is the best, and usually most convenient dressing. The cloth should be applied over the bleeding area and held there firmly by a bandage. If an arm or leg is involved, that part of the body should be elevated above the level of the heart. Unless the wound is minor, the patient should lie down to avoid fainting or shock. It is prudent to clean any dirt out of the wound with a dilute antiseptic, or clean water if no antiseptic is available. Ensure that bleeding has stopped first, and do not disturb any clots that may be present.
Minor cuts will heal without stitching, provided the edges of the wound are not gaping. If the edges do not lie comfortably together, if a joint surface is involved, if the wound continues to bleed or if the scar may be cosmetically disfiguring, then it is essential to see a doctor and have the cut correctly repaired by taping or sutures.