Monthly Medical Minute: Nosebleed

Nosebleeds are common injuries in athletic pursuits; do you know how to correctly treat them?


A RUNNER, AN UNEXPECTED FALL, AND A PAINFUL NOSEBLEED

As the weather warms up, people are becoming more active outside, opening the door for unwelcome injuries. From Spring projects, to sporting activities, to simply getting dressed for that morning jog (yes, read on!), when unexpected injuries happen, the emergency medical team at United Concierge Medicine is here for you.

Bob is an avid runner, the new father of twins, and a dedicated subscriber of UCM's Virtual ER. The added responsibility of twins cuts into his running lifestyle. Therefore, when his wife offered him a short reprieve to go running, he literally “jumped” at the chance before his wife reconsidered! While putting his running shorts on, he tripped—striking his face on the wooden nightstand.

Bob applied pressure to his bleeding nose, and he and his wife immediately called UCM.The UCM emergency medical provider set up video-chat through the UCM app with Bob to better assess him. She discussed Bob’s uneventful past medical history, noted that he was not on any medications, and determined that he did not have a loss of consciousness.

The UCM emergency medical provider coached Bob on properly pinching and holding his nose to stop the bleeding reminding him to not let go of his nose during the following 10 minutes. Additionally, a brief, unremarkable, neurological exam was conducted by our provider with the help of Bob and his wife.

PROVIDING VIRTUAL, EMERGENCY CARE RIGHT AWAY

Although the bleeding stopped, Bob stated that his nasal bridge was exceptionally tender and the UCM emergency medical provider could see considerable swelling local to the nasal bridge. Bob did not have tenderness around the eyes or sinuses and he demonstrated easy breathing through both nostrils. Recognizing that Bob had a fractured nasal bridge without significant deformity, our provider had Bob’s wife grab some Afrin to spray twice in each nostril every 10 minutes, up to three total times, to help with reducing swelling and recurring bleeding.

FOLLOW-UP CARE AND INSTRUCTIONS

Intermittent icing was also recommended over the following 24 hours as well as keeping his head above the level of his heart and limiting any lifting, pushing, or pulling to reduce head pressure. And, lastly, reassurance was given to Bob that nasal bone fractures do not need imaging to diagnose.

Bob knows that he has UCM at his fingertips should he develop any complications and the UCM emergency medical provider advised him to call back with any breathing complications through his nose, with concerning head injury symptoms, and for referrals to local facial surgeons for possible cosmetic issues in the future. She also gave him hope that he’d soon be out on the intended run he was looking forward to sooner than he thought!

DO YOU KNOW WHAT TO DO IF YOU FALL ON A RUN?

An unexpected fall during a run can happen when you least expect it; a cracked sidewalk, an acorn in the wrong spot, or a simple misstep can result in a painful injury far from home — everything from a sprained ankle, to a bad scrape, a pulled muscle or something much worse. But, you're not alone as long as you have your phone and the UCM app ready to go. Within minutes, you can connect with a UCM emergency medical provider and assess your injury. 

A note for runners: Stretching the right way is key to avoiding injuries

You've always heard that stretching before a run is a good way to avoid injury during the run — but do you know the right type of stretching to do not only before, but also after a run? In this article from Runner's World, they explain how dynamic stretches (active movements that stretch your muscles without staying in one position for too long) are important before your run, and post-run, cool-down stretches that address areas that might've become tight are important too.