What is the relevant history in epistaxis (nosebleed)?

Updated: May 08, 2020
  • Author: Quoc A Nguyen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Controlling significant bleeding or hemodynamic instability should always take precedence over obtaining a lengthy history.

Ask specific questions about the severity, frequency, duration, and laterality of the nosebleed. Determine whether the bleed occurs after exercise or during sleep or is associated with a migraine. Determine whether hematemesis or melena has occurred because posterior bleeding in particular may present in this fashion.

Inquire about precipitating and aggravating factors and methods used to stop the bleeding. Most nosebleeds are reported as spontaneous events and are frequently related to nose picking or other trauma; therefore, investigate the various possibilities.


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