We talked in a previous article about the scientific bleeding classifications according to what known in medicine.

You can read the first part of the article from here

In this article I'll tell you about some of special cases of bleeding that may facing you and your children frequently

Special cases of hemorrhage:

Bleeding from the teeth

It may occur, after extraction of the tooth or after trauma or accident or hemorrhagic blood diseases. 

How to deal with such case?

  1. Sit the patient on a chair.
  2. Turn his head to the affected site.
  3. Put a piece of compact gauze, on the site of bleeding and to be above the level.
  4. Ask the patient to compress, firmly on the gauze for about 10-20 minutes. It is easier to put the elbow joint of the patient on table and support the affected jaw with the palm of the hand of the patient.
  5. If the bleeding doesn’t stop, refer the patient to the dentist.

Bleeding from the nose (epistaxis):

It is usually unilateral, but may occur bilateral.

Causes of bleeding:

Local causes:

  • Idiopathic bleeding from (little's area): is the commonest cause in adolescence.
  • Congenital anomalies:in the septum.
  • trauma: as direct blow to the nose, operative trauma or sharp foreign body
  • Inflamatory: atrophic rhinites when the crusts separated.
  • Tumour: benign, as papilloma or angioma in the nose. Malignant tumour as naso-pharyngioma.
  • Deviated septum: Bleeding, may arise from convex or concave side.
  • causes in the nasopharynx: as adenoids.
  • The nose may be an outlet of bleeding from the inside of the skull (fracture base of the skull).

General causes:

  • Ateriosclerosis, hypertension, puberty and violent exercise.
  • High venous pressure, as occurs in mitral stenosis.
  • Fevers, any rise of temperature specially in the children may lead to epistaxis
  • Drugs, specially anticoagulants as heparin and salicylates
  • Blood disease, as hemophilia, leukemia, purpura and jaundice (vitamin k deficiency) or scurvy (vitamin c deficiency).

How to manage This case?

  1. Removal of any tight or heavy clothes. Rest with the head forward (semi -sitting position).
  2. Cold compresses on the forehead.
  3. Pinching the alae of the nose, between two fingers to compress on the little area, after spitting any cloth or oozing discharge.
  4. Adrenaline on a piece of cotton or Vaseline gauze to be put it inside the nostril of the nose (anterior nasal pack) and give vitamin k ampule intramuscular.
  5. If the bleeding is still present, refer to the hospital.

Bleeding from the ear


It may be occurs as a result of wound in the ear or entrance of sharp foreign body inside the ear or from hemorrhagic blood diseases or fracture base.

Treatment of bleeding from the ear:

  • Help the patient to be calm and turn his head to the side of the affected ear .cover the ear completely with sterile dressing, fix it and tie well.
  • Don't put anything inside the ear .Refer the patient to the hospital, for more evaluation.
Dina Sabbah
Pharmacist, Al Azhar University of Gaza graduate. Interested in health awareness .