Nosebleeds: First aid

Overview

Nosebleeds, also called epistaxis (ep-ih-STAK-sis), are common. They happen when the tender blood vessels in the nose break. Common nosebleed causes can include changes of season, dryness, scratching, some medicines and injuries. People on blood thinners may have worse nosebleeds than do others. Most often nosebleeds are only annoying and not a true medical problem. But they can be both.

When to seek emergency help

Seek emergency help if:

• Nosebleeds involve a greater than expected amount of blood.
• Nosebleeds last longer than 30 minutes.
• You feel faint or lightheaded.
• The nosebleed follows a fall or an accident. Bleeding after a fall or an injury to the head or face could mean that you have broken the nose.

Treatment

Follow these steps to treat a common nosebleed.

• Sit up and lean forward. Keep the head up. Lean forward so the blood doesn't go down the throat. This could cause you to choke or have an upset stomach.
• Gently blow your nose. This will clear any blood clots.

• Pinch the nose. Use the thumb and a finger to pinch both nostrils shut. Breathe through the mouth. Keep pinching for 10 to 15 minutes. Pinching puts pressure on the blood vessels and helps stop the blood flow.

  If the bleeding doesn't stop, pinch the nose again for up to 15 minutes. Don't let go for at least five minutes even to check if the bleeding has stopped. Seek emergency care if the bleeding doesn't stop after the second try.

• Prevent another nosebleed. Don't pick or blow the nose. And don't drop the head below the heart or lift anything heavy for many hours. Gently put a saline gel (Ayr), antibiotic ointment (Neosporin) or petroleum jelly (Vaseline) on the inside of the nose. Put most of the salve on the middle part of the nose, also called the septum. Steam, humidifiers or an ice pack across the bridge of the nose also may help.
• If you have another nosebleed, try first-aid steps again. This time, spray both sides of the nose with a nasal spray that has oxymetazoline in it (Afrin). Do this after blowing the nose. Then pinch the nose again. Seek medical help if the bleeding does not stop.

When to contact your doctor

Call a member of your care team if:

• You have nosebleeds often. You may need to have a blood vessel cauterized. Cautery is a method that burns and seals blood vessels using electric current, silver nitrate or a laser. Also, a care provider might pack the nose with special gauze or an inflatable latex balloon. Both packing methods put pressure on the blood vessel and stop the bleeding.
• You have nosebleeds and you're taking blood thinners. If you're taking medicines such as aspirin or warfarin (Jantoven), your care team may change the medicine dose.

Prevention

Think about using a humidifier. Adding more moisture in your home may help relieve nasal bleeding.