from 1 or both nostrils
- Most nosebleeds
(90%) originate from the front part of the nose (anterior nasal septum). Thus,
most nosebleeds will stop when pressure is correctly applied over the bleeding
area. The correct method is to squeeze the soft parts of the nose using thumb
and index finger, thus applying pressure inside of the nose. Hold for 10-15
- Leading causative factors
for nosebleeds include upper respiratory infections (colds) and nose
picking. There is a higher incidence of nosebleeds in the 60-80 year old
age group. Individuals in this age group often have a couple of
causative factors for bleeding. A typical elderly adult with a nosebleed
might be 72, have high blood pressure, and be exposed to dry winter air.
- Causative factors:
- Environmental - Environmental factors include
temperature and dryness of the air.
- Local - Local factors include upper
respiratory infections (colds), nasal drug inhalation, nasal tumors,
nasal septal deviation, too vigorous nose blowing,
and nose picking.
- Systemic - Systemic factors include high
blood pressure, arteriosclerosis, and bleeding problems.
- Medications - Certain medications can
increase bleeding: aspirin, ibuprofen/Motrin, heparin, and coumadin.
See More Appropriate Topic (instead of this one) If
WHEN TO CALL YOUR DOCTOR FOR NOSEBLEED
Call 911 Now (you may need an ambulance) If:
- Too weak to stand following large blood loss
Call Your Doctor Now (night or day) If:
- You feel
weak or very sick
- Bleeding does not stop after 20 minutes of direct pressure
- Bleeding recurs 3 or more times in 24 hours despite direct pressure
- Large amount of blood has
- Skin bruises or bleeding gums not caused by an injury are also
- Pale skin (pallor) of new onset or worsening
- Taking coumadin or known bleeding disorder (e.g. thrombocytopenia)
Call Your Doctor Within 24 Hours (between 9 am
and 4 pm) If:
- You think
you need to be seen
Call Your Doctor During Weekday Office Hours If:
- You have
other questions or concerns
- Easy bleeding present in other family members
- Hard-to-stop nosebleeds are a recurrent problem
Self Care at Home If:
- Mild nosebleed
and you don't think you need to be seen
HOME CARE ADVICE FOR MILD NOSEBLEED
- Sit up and
lean forward, to keep the blood from running down the back of your throat.
Apply Pressure: Gently squeeze the lower soft parts of the nose against
the center wall for 15 minutes. (Goal: apply continuous pressure to the bleeding
point.) Use your thumb and your index finger in a pinching manner. If the bleeding
continues, move your point of pressure and repeat again for another 15 minutes.
Decongestant Nose Drops: If applying pressure fails, insert a gauze
wet with decongestant nose drops (or petroleum jelly). (Reason: the gauze
helps to apply pressure and the nose drops shrink the blood vessels) Then repeat
the process of gently squeezing the lower nose for 10 minutes.
- Decongestant nose drops (e.g. phenylephrine/Neo-Synephrine)
are available over the counter.
- Do not take this medication if you have high blood pressure,
heart disease or prostate enlargement.
- Do not use this medication for more than 3 days. (Reason: excessive
decongestant use can rebound nasal congestion.)
- Read and follow the package instructions carefully.
- If the air is dry, use a humidifier in
your bedroom to keep the nose from drying out.
- Apply petroleum jelly to the center wall (septum) inside the
nose twice daily to reduce cracking and to promote healing.
- Avoid blowing the nose.
- Avoid touching your nose and nose picking.
- Do not take aspirin or other anti-inflammatory medications (e.g.
ibuprofen, Advil, Motrin, Aleve), unless you have been instructed to by your
Expected Course: Over 99% of nosebleeds will stop following 15 minutes
of direct pressure if you press on the right spot. After swallowing blood from
a nosebleed, you may feel nauseated because the blood can irritate your stomach.
You may also later pass a dark stool that contains the blood.
- Call Your Doctor If:
- Unable to stop the bleeding with 20 minutes of direct pressure
- You become worse or develop any of the "Call Your Doctor"
This information is not intended be a substitute for professional medical
advice. It is provided for educational purposes only. You assume full
responsibility for how you choose to use this information.
Adult HouseCalls Online. Copyright © 2000-2004
David Thompson, M.D. FACEP
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