As many small boys know from experience, and others will learn soon, bleeding from the nose, as a rule, ceases spontaneously. Epistaxis then can be classed as a relative emergency by the physician. I do not think any of us need rush to see patients who have epistaxis because if enough time elapses the bleeding of about 80% of them will be checked without treatment. However, it is well to remember that when bleeding is persistent, a serious degree of anemia and occasionally death may result.
Deficiencies in the clotting mechanism of the blood are seldom contributing factors in nasal hemorrhage. The bleeding is oftener due to a leak in the side of a vessel, which simply bursts open. When an older person has such a leaking vessel, the vessel tends to gape because of the sclerotic changes in arteries and veins and atrophy of smooth muscle. The bleeding of
Hallberg OE. SEVERE NOSEBLEED AND ITS TREATMENT. JAMA. 1952;148(5):355-360. doi:10.1001/jama.1952.02930050027006