Stopping the bleeding – Anterior nasal packing

Nosebleeds can be surprising and worrying, especially when they last longer than they should. People often try to stop them on their own, but when they fail, they face the dilemma – is it time to see a doctor? In most cases, anterior nasal packing can quickly solve the problem without further complications. At Dr Prlja Medical in Belgrade, this procedure is performed professionally, quickly, and with care. Not every nosebleed is an emergency, but some should not be delayed. Many people think the procedure is painful or that it makes breathing difficult, which is usually not the case. If your nosebleed recurs or is hard to stop, it is important to know how to proceed. Schedule an appointment with us and solve the problem safely.

What is anterior nasal packing?

Anterior nasal packing is a simple medical procedure used to stop nosebleeds. The doctor carefully inserts sterile gauze into the nasal cavity, layer by layer, until gentle pressure is applied to the bleeding blood vessels. The gauze can be dry, soaked in saline solution, or coated with a special ointment, depending on the need.

This procedure differs from posterior nasal packing in depth and location of application. Anterior packing is used in the vast majority of cases and can be performed on an outpatient basis, while posterior packing is meant for more serious situations and often requires additional measures.

The packing typically remains in the nose for 24 to 72 hours. In some cases, it may be left for up to seven days, as recommended by the doctor. The material used must be soft, sterile, and adapted to the nasal anatomy to ensure maximum comfort for the patient during the recovery process.

How to prevent nosebleeds with anterior nasal packing

The appointment begins with a conversation with our team of ENT specialists and a brief medical history to understand past bleeds and current symptoms. This is followed by local anesthesia with a spray or gel to relax the patient and reduce discomfort. The doctor carefully inserts the packing with the help of a special speculum, pressing it against the bleeding blood vessel. The procedure takes about 10-15 minutes.

Sterile conditions and the careful approach of the doctor make the entire process much more pleasant than many expect. Most patients experience only mild discomfort, but no pain. Additionally, it is possible to breathe through the mouth without significant difficulties during the packing.

When is anterior nasal packing applied?

Anterior nasal packing is one of the most common solutions when nosebleeds cannot be stopped with simple measures. This procedure is used in various situations where it is important to quickly stop the nosebleed and stabilize the patient. It is suitable for mild and moderate cases, but also as a first step in more severe conditions.

The most common reasons for applying anterior nasal packing:

• Bleeding after nasal injury (e.g., impact, fall, scratch)
• Dry and damaged mucosa due to infections or exposure to dry air
• Weak capillaries in older individuals or those with poor vascular structure
• High blood pressure damaging nasal capillaries
• Bleeding caused by the use of anticoagulants or blood-thinning medications
• Chronic, recurrent bleeding without a clear cause
• After nose surgeries, biopsies, or aesthetic procedures
• An additional measure for coagulation disorders or hematological diseases

What can be the cause of bleeding?

Nosebleeds often have various causes. Understanding the underlying cause helps in making the correct medical assessment. Possible causes of epistaxis:

• Surface capillary injuries – often due to scratching, dryness, or a puncture. Bleeding is usually localized and short-lived.
• Hematological disorders – such as clotting disorders or low platelet count, which increase the risk of bleeding.
• Septal perforations – small holes in the nasal septum can cause frequent and heavier bleeding.
• Tumors and nasal polyps – benign or malignant growths in the nasal cavity can cause hidden bleeding.

The diagnostic value of an ENT nasal examination during nasal packing is significant, as it can reveal changes in the nasal mucosa, presence of polyps, tumor formations, or septum damage. If the doctor notices any of these causes, they may recommend additional imaging, lab tests, or a biopsy. Quick and accurate diagnostics greatly increase the chances of successful treatment.

How to care for yourself during nasal packing

During the packing, you will adjust your breathing through your mouth. This is normal and does not cause any issues. It is recommended to drink plenty of fluids to avoid dryness. At night, sleep on your back with your head slightly elevated – use an extra pillow. This will reduce pressure and the risk of rebleeding.

Avoid sudden head movements or straining when blowing your nose. Also, during the day, do not wear glasses that press on your nose – you can use contact lenses if you usually wear them. These simple adjustments will help ease recovery and make your day more comfortable.

Removing the packing

When the doctor decides it’s time to remove the packing, the step is usually done after 24 to 72 hours in an outpatient setting. The procedure is quick and relatively painless, with minimal pressure – the patient feels brief discomfort but no severe pain. Do not attempt to remove the packing yourself. Self-removal can cause rebleeding or displacement of the packing material.

During recovery, the mucosa needs to be regularly moisturized. Saline solutions or seawater sprays are recommended, especially in dry air. Avoid strenuous activities, such as lifting weights, swimming, or sudden head movements within the first 48 hours. Also, you should avoid straining when blowing your nose or passing a tissue through your nose. By following these measures, recovery will proceed faster and without complications.

How long does recovery take, and what to expect after the procedure

Recovery after anterior nasal packing typically lasts a few days. Mild pressure, discomfort, and sensitivity may last another day or two, which is completely normal. You can return to regular activities after a check-up, but without strenuous efforts or exposure to dry air. If new bleeding, pain, fever, or difficulty breathing occurs, you should immediately contact an ENT specialist.

Complications and more serious issues that nasal packing can prevent

Anterior nasal packing is not only used to stop nosebleeds. It also helps prevent potentially serious symptoms or complications. It is used to:

• Prevent blood from draining into the throat or mouth
• Treat vertigo, weakness, or low blood pressure
• Reduce the risk of anemia or infection due to prolonged exposure to blood

Anterior nasal packing can significantly reduce the risk of losing a large amount of blood and help prevent serious conditions like hypovolemic shock. While it does not guarantee that epistaxis will not recur, it greatly lowers the chance of reoccurrence in the short term. Therefore, it is important to act promptly and schedule an ENT exam, where a specialist will assess how to prevent nosebleeds. In some cases, deeper causes may be suspected, such as:

• Chronic sinusitis
• Coagulation disorders
• Nasal septum deviation
• Tumor changes in the nose

The doctor may then recommend additional diagnostics:

• Endoscopic examination of the nose
• Laboratory tests
• Blood coagulation testsi

Stop the nosebleed on time with the expert help of our ENT team in Belgrade

Nosebleeds may not indicate a serious problem, but when they recur or don’t stop, it’s time for professional help. Anterior nasal packing is a safe and quick procedure that can prevent more serious complications. At Dr Prlja Medical in Belgrade, you receive thorough evaluation, expert treatment, and continuous support. Our team consists of experienced ENT doctors who approach each patient with care. The clinic is modernly equipped and located in a convenient area in the city center. The procedure is performed in sterile conditions and with maximum comfort. If you need an exam or treatment, don’t wait. Addressing the problem early reduces the risk of rebleeding and speeds up recovery. Schedule your appointment today and resolve your breathing problem safely and without delay.