Primary prevention

Primary preventive measures include:

  • Avoiding picking or rubbing inside the nose.

  • Home humidification.

  • Application of saline spray, or saline nasal gels, in order to discourage intranasal excoriation and thereby help preserve mucosal integrity.

See also the Patient discussions section of this topic.

Secondary prevention

Secondary preventive measures are the same as primary preventive measures.

Further preventive measures include avoiding trauma from nose picking and employing simple nasal hygiene.[5] If possible, avoid drugs that impairs clotting, such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), particularly in people who have recurrent epistaxis. These drugs do not initiate nosebleeds but may prolong bleeding.

Patients on nasal oxygen or continuous positive airways pressure should use their humidification apparatus to reduce nasal mucosal drying which contributes to recurrent nosebleeds.[5]

Avoid drugs that impairs clotting, if possible, during healing.[7][8][44]

Advise patients taking anticoagulants or antiplatelet agents to use saline lubrication and ensure that comorbidities are well controlled to prevent recurrent epistaxis.[5]

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