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What do I need to know about a nosebleed?

A nosebleed, or epistaxis, occurs when one or more of the blood vessels in your nose break. You may have dark or bright red blood from one or both nostrils. A nosebleed can be caused by any of the following:

  • Cold, dry air

  • Trauma from picking your nose or a direct blow to your nose

  • Abnormal nose structure, such as a deviated septum

  • Irritation or inflammation from a cold, respiratory infection, or allergies

  • An object stuck in your nose

  • Certain medicines, such as blood thinners

How is a nosebleed diagnosed?

  • A nasal exam may show blood clots or swelling. Your healthcare provider will use an instrument called a speculum to check the inside of your nose. This gently opens your nostrils so your healthcare provider can see what part of your nose is bleeding.

  • A nasal endoscopy is a deeper exam of the inside of your nose. Your healthcare provider uses a scope (thin, flexible tube with a light and camera on the end) to see further into your nose.

What first aid should I do for a nosebleed?

  • Sit up and lean forward. This will help prevent you from swallowing blood. Spit blood and saliva into a bowl.

  • Apply pressure to your nose. Use 2 fingers to pinch your nose shut for 10 to 15 minutes. This will help stop the bleeding.

  • Apply ice on the bridge of your nose to decrease swelling and bleeding. Use a cold pack or put crushed ice in a plastic bag. Cover it with a towel to protect your skin.

  • Pack your nose with a cotton ball, tissue, tampon, or gauze bandage to stop the bleeding.

How is a severe nosebleed treated?

You may need any of the following if the bleeding does not stop after first aid is done:

  • Medicines may be applied to a small piece of cotton and placed in your nose. Medicine may also be sprayed in or applied directly to your nose. You may need medicine to prevent an infection. If bleeding is severe, medicine may be injected into a blood vessel in your nose.

  • Cautery is when a chemical or electric device is used to seal the blood vessels. This may be done to stop bleeding or prevent more bleeding. Local anesthesia may be used.

  • Nasal packing is when layers of gauze are placed in your nose to provide pressure and stop the bleeding. Local anesthesia may be used. Nasal packing is usually removed in 2 to 3 days.

  • Embolization is a procedure used to stop the bleeding from inside your nose. Medical glue or a small balloon device may be used to clog the blood vessels in your nose.

  • Surgery may be needed if your nosebleed returns over and over long-term. An artery may be tied to stop bleeding. Damaged tissue or an abnormal structure in your nose may be repaired.

How can I help prevent another nosebleed?

  • Keep your nose moist. Put a small amount of petroleum jelly inside your nostrils as needed. Use a saline (saltwater) nasal spray. Do not put anything else inside your nose unless your healthcare provider says it is okay.

  • Use a cool mist humidifier to increase air moisture in your home. This will help your nose stay moist.

  • Do not pick or blow your nose for at least a week. You can irritate or damage your nose if you pick it. Blowing your nose too hard may cause the bleeding to start again. Do not bend over or strain as this can cause the bleeding to start again.

  • Avoid irritants such as tobacco smoke or chemical sprays such as cleaners.

When should I seek immediate care?

  • Your nose is still bleeding after 20 minutes, even after you pinch it.

  • Your nasal packing is soaked with blood.

  • You have a foul-smelling discharge coming out of your nose.

  • You feel so weak and dizzy that you have trouble standing up.

  • You have trouble breathing or talking.

When should I contact my healthcare provider?

  • You have a fever and are vomiting.

  • You have pain in and around your nose.

  • Your nasal pack is loose.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.