How to Treat a Nosebleed
Nosebleeds are a common medical problem; usually they are mild and easily managed without the need to see a medical provider.
The lining of the nose is very delicate. Any irritation to the nose can injure a small blood vessel and cause bleeding. Irritation may be caused by excessively cold or dry air, or by direct injury to the nose from trauma, fingertips, Q-tips, or vigorous nose blowing. As people age, blood vessels within the nose become more delicate and prone to injury. Anti-coagulated individuals (e.g Coumadin, Xarelto, aspirin, fish oil) are more susceptible to prolonged nose bleeds.
In the event of a nosebleed, we recommend that patients do the following:
- Sit upright so that the nose is higher than the heart.
- Lean forward, tipping the face downward, and tucking your chin to your chest; this facilitates blood flow out of the nostrils instead of down the back of the
- Pinch the nostrils closed tightly near the tip of the nose to prevent an blood loss through the nostrils; the blood pooling in the nose will clot and seal the source of
- Hold pressure on the nostrils for 10 minutes by watch or clock, without letting blood drain through the nostrils.
- After 10 minutes, release the nasal pressure, and if bleeding persists, hold pressure on the nostrils in the same way for another 10 minutes again using a clock or watch to ensure pressure is held for the full 10 minutes.
- Do not blow your nose or sniff in vigorously at any point, as this interrupts the clot that is forming to stop the bleeding; in addition, if you must sneeze, do so through an open mouth.
- If bleeding persists, you can spray 2-3 sprays of Afrin or Neo-Synephrine nasal spray into the nose and hold pressure 10 minutes one additional time.
- If bleeding persists after holding pressure 3 times in a row, each for 10 minutes, contact your doctor or go to an Emergency Room.
If you have just had cautery:
- Avoid nose blowing for 1 week.
- 2 days after cautery, begin saline nasal spray 4 sprays to the inside of the nose 4 times per day for 2 weeks.
- 2 days after cautery, begin applying Bacitracin, Aquaphor or Vaseline to the inside of the nose 3 times per day for 2 weeks.
- Call if bleeding recurs.