The first aid measure to be taken to stop bleeding due to epistaxis

NHM UP Staff Nurse-2021 Shift-1st

Medical & Surgical Nursing

Easy

Appeared in: NHM UP Staff Nurse-2021 Shift-1st

Explanation

The correct procedure involves having the person sit upright and lean forward.
Sitting upright helps to lower the blood pressure in the veins of the nose.
Leaning forward prevents blood from being swallowed or aspirated into the lungs, which can cause nausea, vomiting, or choking.
Direct pressure should be applied by pinching the soft, fleshy part of the nose against the septum.
This action compresses the blood vessels in Kiesselbach's plexus, the most common site for anterior nosebleeds, promoting clot formation.

Option A: Leaning backward is incorrect and potentially dangerous. It causes blood to drain down the throat, which can lead to swallowing blood (causing nausea/vomiting) or aspiration into the airway.
Option C: Lying down is incorrect because it can increase venous pressure in the head, potentially worsening the bleeding. It also increases the risk of blood draining into the throat and being aspirated.
Option D: This option is incorrect for two reasons: the person is lying down, and pressure is applied to the wrong location. Pinching the top, bony part of the nose does not compress the bleeding vessels located in the soft, anterior portion.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain First aid management of epistaxis (nosebleed) as background academic context rather than a clinical decision trigger.
Correct first aid for epistaxis is a critical nursing skill to prevent complications like aspiration pneumonia and to manage a common medical complaint effectively.
Nurses must educate patients and families to discard the myth of tilting the head backward, as it poses a significant safety risk.
Patients should be advised to seek medical attention if bleeding is severe, lasts longer than 20 minutes despite pressure, or follows a head injury.

How to Approach the Question

First, identify the clinical problem presented in the question: managing epistaxis (a nosebleed).
Recall the primary goals of first aid for bleeding: stop the hemorrhage and prevent complications.
Evaluate each option based on three key actions: body position (sitting vs. lying), head tilt (forward vs. backward), and the point of pressure application (soft vs. bony part of the nose).
Analyze the rationale for each action. Sitting up and leaning forward prevents aspiration. Pinching the soft part applies direct pressure to the most common bleeding site (Kiesselbach's plexus).
Eliminate options that include incorrect or harmful actions, such as leaning backward, lying down, or pinching the bony bridge.
Select the option that combines all the correct and safe first aid measures.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 42-44

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 334-336