Tuesday, March 18, 2014

Nosebleeds: Hollywood-- Please Stop.

There are a few things that parents freak out about that are of minor concern to us in the pediatric emergency department.

One of those is the nosebleed. Particularly living in a dry state like Colorado-- nosebleeds happen. Your nasal tissue is very vascular so if it becomes dry and irritated, it won't take much to get a nosebleed started. Generally, all that is needed is a little extra moisture. A humidifier in the room. Some saline nose drops and perhaps some Vaseline applied to the inside lower portion of the nostril to resolve.

In my twenty plus years of nursing, I've never seen a nosebleed be a sign of any horrifying diagnosis. I'm not saying that it can't be (and this is what likely sends most parents to the ER) but it would be an uber-rare event.

But Hollywood seems to have a fascination with nosebleeds. Anytime a character is using any increased mental prowess or mental super power-- this is signified by a nosebleed.

In fact, I found some support of this ridiculousness with this blog post on 7 Most Ridiculous Psychic Nosebleeds in Movies and TV. It's genius. 

And it has become an annoyance of mine.

Evidently, the medical assumption is that there is soooo much pressure in the brain from all this mental sommuersaulting that it has caused the nose to start bleeding.

If that were true, then we would see medical correlation for this. I've worked in intensive care where patients have had measured increased intracranial pressure to the point that they herniated (or shifted) their brain to places it shouldn't go.

And still-- no nosebleed.

Your nasal tissue isn't in direct communication with your brain (it's not part of that cavity) so it doesn't make sense for a nosebleed to be evidence of increased brain pressure.

The only instance this might be medically reasonable is when there is a basilar skull fracture where the bones that line the bottom of your skull break. Then there does become a correlation between your brain and your sinus cavity and drainage from the nose can happen in that instance.

But otherwise-- Hollywood-- let's let the nosebleed go.


  1. Jordyn, your post is on the nose (please excuse the pun--couldn't help it). I practiced otolaryngology for thirty-six years, ten as a professor at a prestigious medical center, and as I recall I saw epistaxis (nosebleeds) as a presenting sign of something serious (lethal midline granuloma, Wegener's granulomatosis, etc.) perhaps a half dozen times. Most nosebleeds are due to dry air, nose-picking, cocaine usage, uncontrolled hypertension, or a septal perforation, and can be managed conservatively. However--and this warning is always appropriate--if symptoms persist, see your doctor.

    1. Richard,

      I always appreciate your medical back-up! Especially when this is your area of expertise. And thanks for listing out the most common reasons for nosebleeds.

  2. I had an elderly Spanish teacher in seventh grade, and one day a fellow student, Kelly, had a nosebleed in class. (This was in Wyoming, so dry air was probably the culprit.) The teacher actually told her she might have a brain tumor, and Kelly became distraught. Fortunately, her father was a brain surgeon; they had to call him at work to pick her up and calm her. All over ONE nosebleed.

    1. That is truly AWFUL. Oh my word, I think I would have had a little chit chat with that teacher. How traumatizing for the child. Good thing her dad could talk some sense to her and the teacher. But, you'd be surprised how many will take a medical diagnosis from a non-medical person. "My Aunt Jean the plumber says . . . "

    2. True, Jordyn. Or from a random website. Or from a novel or movie, which as you point out in this blog entry, may or may not be based on reality! :D Common sense says to take the source into consideration, people. LOL!