Examination: 1. Take detailed medical history and bleeding to confirm that the bleeding originates from the nasal cavity or adjacent tissues and exclude hemoptysis and vomiting. 2.Determine the site of bleeding, combined with anterior rhinoscopy, nasal endoscopy or CT or MRI examination. 3.Blood routine examination is essential for patients with large bleeding volume and suspected hematological disease. For patients applying anticoagulant drugs and suspected abnormal coagulation function, coagulation function needs to be checked. 4.Estimate the amount of bleeding, assess the patient’s current circulatory system condition and the presence of hemorrhagic shock, and consult with relevant departments if necessary. The amount of bleeding is judged comprehensively according to each bleeding situation and the number of episodes, the patient’s blood pressure, pulse rate, general condition and laboratory tests. When the blood loss reaches 500ml, symptoms such as dizziness, thirst, weakness and pallor may appear. When the blood loss reaches 500-1000ml, sweating, decreased blood pressure, rapid and weak pulse may occur. If the systolic blood pressure is lower than 80 mmHg, it indicates that about 1/4 of the blood volume has been lost. 5. Examine systemic disorders. Differential diagnosis 1. hemoptysis Blood is hemoptysis through the mouth after bleeding from the larynx, trachea, bronchus and lungs. It is commonly seen in pulmonary tuberculosis, bronchiectasis, lung cancer, lung abscess and pulmonary stasis caused by heart disease. It can be identified according to the patient’s past medical history, physical signs and auxiliary examinations. 2.Vomiting blood Vomiting blood is one of the main manifestations of upper gastrointestinal bleeding. When a large amount of blood is vomited, blood can gush out from the mouth and nasal cavity, often accompanied by other symptoms of gastrointestinal diseases, and there can be positive signs in the whole body examination, which can be distinguished.