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Nosebleed

AMBULATORY CARE:

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 is most commonly caused by dry air or picking your nose. A direct blow to your nose, irritation from a cold or allergies, or a foreign object can also cause a nosebleed.

Seek care immediately if:

  • 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.

Contact your healthcare provider if:

  • 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.

First aid:

  • 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. Breathe through your mouth.

  • 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.

Treatment for a severe nosebleed

may include 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.

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. Do not use oil-based lubricants if you use oxygen therapy. They may be flammable.
  • 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.

Follow up with your healthcare provider as directed:

Any packing in your nose should be removed within 2 to 3 days. Write down your questions so you remember to ask them during your visits.

© 2016 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.

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.

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