Epistaxis: con este nombre poco conocido se denomina al sangrado de nariz, una hemorragia que se origina en las fosas nasales y que, generalmente, responde a un problema leve.
En la inmensa mayoría de los casos estamos ante un trastorno banal, explica la Sociedad Española de Médicos de Atención Primaria (SEMERGEN), porque suele perderse escasa cantidad de sangre (a pesar de lo alarmante que pueda parecer) y porque lo habitual es que la hemorragia se detenga rápidamente de manera espontánea o mediante la compresión. Sin embargo, en algunas ocasiones la epistaxis sí puede llegar a ser grave si el sangrado no se corta (en personas que se tratan con anticoagulantes, por ejemplo). El trastorno se puede producir a cualquier edad, pero es más habitual en niños que rondan la adolescencia y en adultos a partir de los 50 años.
¿Qué la provoca?
En niños pequeños puede deberse a la presencia de un cuerpo extraño en la vía nasal o simplemente responder al hábito de hurgarse la nariz. También es común que el sangrado se deba a resfriados o rinitis o a la sequedad de la mucosa (por agentes irritantes como el humo o por la sequedad ambiental). Los pólipos nasales, la tensión arterial descontrolada o ciertas enfermedades sistémicas también pueden estar en el origen de la epistaxis, así como algunos medicamentos (anticoagulantes, heparinas o ácido acetilsalicílico) más habituales en la población anciana.
¿Cómo actuar?
⊕ Colocarse inclinado hacia delante y con la cabeza hacia abajo
⊕ Si se trata de un niño, comprobar que no hay ningún cuerpo extraño en la nariz
⊕ Colocar algodón o gasa impregnada en agua oxigenada en la fosa sangrante evitando friccionar la mucosa y comprimir durante al menos 10-15 minutos
⊕ Medir la tensión arterial por si es debido a una descompensación
A urgencias si…
El sangrado persiste, especialmente en personas con tensión arterial descontrolada o que estén en tratamiento con aspirina, heparinas o anticoagulantes.
En el caso de los niños, si hay sospechas de algún cuerpo extraño será conveniente acudir al médico de urgencias para la valoración y extracción del mismo.
NUNCA: La creencia de que en estos casos hay que echar la cabeza hacia atrás para intentar detener la hemorragia es todo un error, es más, está contraindicado ya que la sangre puede fluir hacia la garganta.
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