Approach to Nosebleeds
Nosebleeds (epistaxis) are very common — about six in ten people experience at least one in their lifetime. The great majority arise from a network of vessels at the front of the septum (Little's area) and stop with simple measures. Knowing correct first aid prevents unnecessary panic and hospital visits.
Correct first aid, step by step
- Stay calm and sit up; tilt your head slightly forward. (Tilting back is wrong: blood runs down the throat and causes nausea and vomiting.)
- Pinch the soft (winged) part of the nose between thumb and index finger, continuously, for 10–15 minutes. Pressing the bony bridge does not help.
- Breathe through your mouth; do not keep releasing to check.
- Ice on the bridge of the nose or neck may help.
- After bleeding stops, avoid nose-blowing, heavy lifting and hot showers for several hours.
When to go to hospital
- Bleeding that continues despite 20 minutes of correct pressure
- Bleeding after trauma, especially with deformity
- Heavy bleeding in people on blood thinners
- Continuous blood running down the throat, weakness, cold sweats
Causes of recurrent nosebleeds
Dry air and nose-picking are the most common causes. Others include allergic rhinitis, septal deviation, steroid or decongestant spray use, hypertension, anticoagulants and clotting disorders. One-sided bleeding with foul discharge, or bleeding that steadily worsens, requires endoscopic examination to exclude masses inside the nose.
What does the ENT specialist do?
The bleeding point is identified on examination. Superficial vessels that bleed repeatedly can be sealed by cautery (chemical or electrical) within minutes, in the office. Resistant cases may need packing, endoscopic intervention or rarely vessel ligation. Saline sprays and moisturising ointments help prevent dryness-related bleeds.
Frequently Asked Questions
How do you stop a nosebleed?
Stay calm, sit up and tilt your head slightly forward; tilting back is wrong because blood then runs down the throat. Pinch the soft, winged part of your nose between thumb and index finger continuously for 10-15 minutes and breathe through your mouth during this time.
Should you tilt your head forward or back during a nosebleed?
Your head should be tilted slightly forward. Tilting it back is a mistake because the blood runs down the throat and causes nausea and vomiting, and it also hides whether the bleeding has really stopped.
When should I go to hospital for a nosebleed?
Seek care without delay if bleeding continues despite 20 minutes of correct pressure, if it follows trauma and there is a deformity, if it is heavy in someone on blood thinners, or if there is continuous blood running down the throat with weakness and cold sweats.
Why do I keep getting nosebleeds?
The most common causes are dry air and nose-picking. Others include allergic rhinitis, septal deviation, spray use, high blood pressure, blood thinners and clotting disorders; one-sided bleeding with foul discharge or steadily worsening bleeding needs endoscopic examination to rule out masses in the nose.
What does an ENT doctor do for recurrent nosebleeds?
The bleeding point is identified on examination, and superficial vessels that bleed repeatedly can be sealed by cautery (chemical or electrical) within minutes in the office. Resistant cases may need packing or endoscopic intervention, and saline sprays and moisturising ointments are advised to prevent dryness-related bleeds.
Would you like to book an appointment?
You can call our office or pick a convenient time slot on DoktorTakvimi.