Nosebleeds

Video 30 of 46
3 min 8 sec
English, Español
English, Español

In this lesson, we're going to cover nosebleeds and how to apply first aid in the event you or someone you know gets one.

Nosebleeds, also known medically as epistaxis, can catch us off guard and happen when we least expect them. However, they’re often quite harmless and can usually be managed easily.

Each year, around 60 million people get nosebleeds in the United States alone. They are mostly likely to occur in the winter when cold weather and indoor heating dry the nasal passages. Most nosebleeds are minor and the bleeding will often stop on its own, but some people may require medical attention.

This lesson will teach you the proper way to handle them. But before we proceed, bear in mind that while most nosebleeds are benign, there are exceptions.

Pro Tip #1: If a nosebleed is intense, continues for over 20 minutes, or pairs with other symptoms, one should seek immediate medical help. It's important to note that if someone is on prescription blood thinners, their risk of a continued hemorrhage increases significantly, as these medications can intensify bleeding and challenge the standard control techniques. It's important and recommended that these patients seek further medical attention.

First Aid Steps for Nosebleeds

While nosebleeds are usually nothing to worry about, the presence of blood can make people feel anxious or queasy, particularly if it is their own blood.

  1. Reassure the affected person and urge them to stay calm.
  2. Ask the nosebleed victim to sit down and lean forward slightly, as this helps keep the blood from trickling down the back of the throat.
  3. Once you have your safety gloves on, or if the individual can do it themselves, pinch the soft section of the affected person's nostrils just past the nasal bone.
  4. Hold this pinch for about 10-15 minutes without releasing any of the pressure. This simple act applies pressure on the blood vessels of the nose and helps facilitate clotting.
  5. If the victim has any blood pooling in their mouth or throat, instruct them to carefully spit it out rather than swallow it. It is important to contain the blood spray or splatter through this process, which can be associated with sneezing, coughing, spitting, or speaking.

Pro Tip #2: A backward tilt could lead to potential complications like aspiration and vomiting. So step two is more vital than it may sound.

Eye protection along with a face shield may be necessary - in addition to gloves – to fully protect the care provider appropriately. If no PPE (Personal Protective Equipment) is available, be sure to stand next to the patient, rather than in front of their face, as this may help protect you.

Pro Tip #3: It's important to note that while a cold compress can help constrict blood vessels, cold blood does not clot swiftly. If you choose to use an ice pack, it is suggested to be placed on the bridge of the nose or the rear of the neck.

Once the victim's nose stops bleeding, encourage the patient to resist the urge to blow their nose, as this can dislodge the clot and cause the nose to begin bleeding again.

One common misconception is to pack the nose with gauze or tissue. This should be avoided in a first-aid scenario. And remember, only a physician should decide on medical nose packing. Also, for those patients who may be on blood thinners, the pressure might need to be maintained longer, and a physician's intervention may be required.

Utilizing these first-aid methods, most nosebleeds can be managed easily. But remember, persistent bleeding, recurring episodes, or additional symptoms or complications may warrant prompt medical attention via a 911 emergency services phone call.

A Word About Applying Pressure to a Stubborn Nosebleed

The two most important factors when successfully controlling a nosebleed are:

  1. The amount of pressure applied.
  2. The amount of time the pressure is maintained.

Remember that the pressure must be firm, and it must be maintained for a long time.

Methods of applying pressure include pinching the nose with your fingers or using gauze or cloth placed over the nose and then pinching. If bleeding continues, do not remove the gauze. Add more gauze on top of the old and apply more pressure.

If it is not possible to provide continuous manual pressure, wrap an elastic bandage firmly over the gauze to hold it in place. However, be sure that the amount of pressure remains adequate.

About Hereditary Hemorrhagic Telangiectasia

HHT is a genetic disorder in which blood vessels do not develop normally leading to bleeding that can be serious or life-threatening.

A person with HHT may form abnormal capillaries or abnormal capillary connections between the arteries and veins. Capillaries are tiny blood vessels that pass blood from arteries to veins. The abnormal blood vessels formed in HHT are often fragile and can burst, which then causes bleeding.

Men, women, and children from all racial and ethnic groups can be affected by HHT and experience the problems associated with this disorder, some of which are serious and potentially life-threatening.

Nosebleeds are the most common sign of HHT, resulting from small abnormal blood vessels within the inside layer of the nose. While rare, it's important to understand that sometimes a nosebleed is a sign of a greater underlying problem.