February 13, 2016

The Nosebleed

This is not my story, but it made me laugh so I had to share.

An airport medic I work with was assigned to the report of an epistaxis at one of the airline gates. For those of you who aren’t from Colorado, nosebleeds are pretty common due to dry air and an apparent propensity for Coloradans towards forceful and insistent nosepicking. So epistaxises (espistaxi?) are common and not usually a big deal, outside of hypertension, blood thinners, or trauma. We get called because people don’t know how to stop them. Rather than applying pressure by squeezing the nares against the septum, most people go with the dab and check approach. But there are other ways that people try to stop nosebleeds.
This is a lithograph from the 1830s showing a maid attempting to stop a man's nosebleed by putting a key down his shirt. Source

The medic arrived to find a young girl with a little blood on her upper lip, from a minor right nare nosebleed. She was about 10-years old, so blood thinners and hypertension were not a problem. There was no trauma reported. This call looked to be no big deal, except for the whiskey-tango-foxtrot dynamic.

See, she was lying on the filthy airport floor with her arms extended over her head and one shoe and sock off. An airline representative was intently slapping the sole of her bare foot.

Whiskey. Tango. Foxtrot. What in the unnatural f*** is going on here? our hero thought to himself.

The patient’s mother immediately told our medic that his help was not wanted. Mom seemed to be unimpressed with the nosebleed, and didn’t want any more of a scene to be made. The medic is like me in that he wasn’t looking for excuses to inflict unwanted care upon a patient who didn’t need it. But he also knew he couldn’t leave things like this, either. So he vocalized his bewilderment to the footslapping airline worker: “Excuse me. What are you doing to her?”

“Taking care of her nosebleed,” the representative answered without looking up, as though it was obvious. Smacksmacksmack, she continued her work on the bottom of the girl’s foot.

“I am swallowing the blood,” said the supine patient.

The medic definitely couldn’t let that statement pass, so he had the young girl sit up. He cleaned her face up and put a plastic clamp on her nose.

“You’re doing that wrong,” the airline agent told him, crossing her arms irritably. “A paramedic taught me to take care of nosebleeds and that is not the right way.”

By this point, the medic in question was not only confused but also rather frustrated. He asked the airline employee what she was talking about. I can only assume that he asked in a sarcastic manner with barely veiled hostility.

“The paramedic taught me to lie the patient down, put their arms over their head, remove their shoes and socks, and hit each of their feet very hard three times. That way the blood in their body thinks they are standing up and it goes to their feet. If there is blood in their feet, it won’t come out of their nose. But she is only a little girl, so I didn’t want to hit her hard. That is why her nose is still bleeding.”

That's why her nose is still bleeding. Of course.

The point of this story is that one of my paramedic peers told the gate agent that ridiculous and convoluted process to stop nosebleeds. Apparently they told the agent in a serious way, with a straight face.

She. Believed. It.

If you are the one who told the airline rep the hysterically “proper” way to manage a nosebleed: You, sir or madam, are sincerely and deeply awesome. You are my hero. I wish I could buy you a beer for that one…

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