Epistaxis, a hemorrhage from the nose, is caused by the rupture of tiny, distended vessels in the mucous membrane of any area of the nose.
A 14 year old male comes into the emergency with complaints of dizziness, headache, bloody vomitus. He has been nose bleeding for three days & actively for 24hours. The accompanying guardian has had him lean back in an effort to stop the bleeding. On assessment he has cold clammy skin and is weak looking while being pale with some confusion. Vital signs: