Teaching Dr. Oz about nosebleeds

A reader informed me that Dr. Oz did a TV show recently on nosebleeds.

I took a look at the video clip and it is my opinion that some information Dr. Oz conveyed is not entirely correct. Again, I should stress that this is just my opinion and I’m sure there will be many who may feel differently.

Error #1:
Contrary to what was said on the show, ice packs do not help with nosebleeds significantly. Though it makes sense that cold constricts the blood vessels… it does so only at the level of the skin surface and not so much inside the nose where the bleeding is occurring. If it does, it is only to a marginal degree.

Error #2:
Contrary to Dr. Oz’s statement, pushing under the upper lip does not help much to stop nosebleeds. Dr. Oz is correct in stating that blood vessels that contribute to nosebleeds are squeezed shut by this maneuver, but unfortunately, there are several other blood vessels that still supply blood for the nosebleed. The most common location for responsible for over 90% of nosebleeds is in the anterior septum in an area called Kiesselbach’s plexus. This plexus is supplied by several blood vessels including:

• anterior ethmoid artery
• great palatine artery
• sphenopalatine artery
• superior labial artery

Only the last artery (superior labial artery) is squeezed shut by pressing under the upper lip. The other three arteries are still pumping away.

Error #3:
Glycerin based liquid applied to the outside of the nose does not do much good either. That’s like saying placing chapstick on your chin will helped with healing chapped lips. The application needs to occur directly in the region of the nosebleed. Personally, I’m not a fan physical application of any type of ointment into the nose whether by finger or Q-tip. Rather, I recommend use of nasal sprays or nasal drops to get the medication into the nose. My personal favorite is PonarisTeaching Dr. Oz about nosebleeds nasal drops.

So what did Dr. Oz get right?

• Do squeeze the fleshy part of your nose together (not on the bone). This applies direct pressure on the most common location of nosebleeds. Pressure is key, just like a stabbing victim has rescuers putting direct pressure where the bleeding is coming from.
• Do lean slightly forward to prevent blood from draining down into the throat where one may swallow the blood which would result in nausea and potentially vomiting.

Christopher Chang is an otolaryngologist who blogs at Fauquier ENT Consultants blog.

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  • http://doctorstevenpark.com Steven Park. MD

    I would have been interesting if he explained how high altitude may or may not be related to increased rates of nosebleeds.

    Regardless of all the inaccuracies, it was a fun segment.

    There are now various over-the counter clot enhancing options, similar to what we use for sinus surgery.

    Now that the winter season is upon us (in NY), using a humidifier at night is a good way of preventing nosebleeds.

    http://doctorstevenpark.com

  • Ellen

    One thing I learned in Med. school that seems controversial, is the concept that gently blowing the nose as soon as the nosebleed starts, clears the nostrils of attached mucus, etc., so pressure is more effective. What do others believe in this regard?

  • Brian

    Dr. Oz not correct? Color me unsurprised.

  • http://drpullen.com Ed Pullen

    Agreed. How does a cardiovascular surgeon seem to think he is an expert in primary care and every medical specialty. I think his specialty is his seduction of Oprah.

  • http://ethicalnag.org/2010/09/01/celebrity-doctors/ Carolyn Thomas

    Dr. Tom Linden, professor of Medical & Science Journalism at UNC Chapel Hill once told the Los Angeles Times that today’s celebrity doctors can be divided into two broad categories: medical journalists and medical showmen. I suspect Dr. Oz has morphed into the latter. Dr. Linden explains:

    “Journalists operate under journalistic principles. The showmen operate outside the sphere of journalism and are in the world of informational entertainment.”

    I guess that’s where the subject of nosebleed treatment falls.

    I’m so embarrassed for Dr. Oz, with his game-show-style revival meeting hype, his roster of anti-aging plastic surgeon pals, and show topics like “Four Libido Super-Foods that will Save your Relationship”. Oh, please….

    More at “What Has Happened To You, Dr. Oz?” at http://ethicalnag.org/2010/09/01/celebrity-doctors/

  • Scott

    He also failed to mention that frequent nosebleeds, especially if there is a family history of them, can be a sign of Hereditary Hemorrhagic Telangiectasia (HHT). HHT is a genetic disease of abnormal blood vessel development that leads to nosebleeds in many affected pateints. Abnormal blood vessels can also lead to stroke and brain infection.

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