Epistassi

Epistassi, also known as epistaxis or a nosebleed, is the acute loss of blood from the nasal cavity or nasal mucosa. It is a common medical event that can affect people of all ages, with higher frequency in children and older adults. Most episodes originate from the anterior part of the nasal septum (Kiesselbach's plexus), while less often they arise from the posterior nasal cavity (sphenopalatine artery) and can be more severe.

Causes and risk factors include nasal trauma (such as nose picking or injury), dry indoor air, upper respiratory infections, allergic rhinitis, and other upper airway inflammations. Structural issues like a deviated septum, chronic sinusitis, or nasal foreign bodies can contribute. Systemic factors include hypertension, coagulation disorders, liver disease, and anticoagulant medications. Recurrent episodes may indicate an underlying medical condition or medication effect and warrant medical evaluation.

Symptoms typically involve sudden bright red bleeding from one or both nostrils, sometimes with accompanying nasal discharge, lightheadedness, or fatigue if the bleeding is heavy. Most episodes are self-limited and stop with simple first aid. When assessing epistassi, clinicians check vital signs, nasal exam to identify the bleeding source, and assess for signs of serious bleeding or life-threatening conditions.

Treatment focuses on stopping the bleed and preventing recurrence. First aid steps include sitting upright, leaning forward, and pinching the soft part of the nostrils for 5–10 minutes; breathing through the mouth and applying a cold compress can help. After bleeding stops, avoid nose blowing for 24 hours. Medical care is needed if bleeding persists beyond 20 minutes, if there is heavy or recurrent bleeding, signs of anemia or shock, or suspected posterior epistaxis. Medical options include topical vasoconstrictors, anterior nasal packing, cauterization of a visible vessel, or endoscopic evaluation for posterior bleeds. Prevention focuses on humidification, saline nasal sprays, avoiding nose trauma, and managing contributing conditions or medications.