Epistaxis

Epistaxis

Why do people get nosebleeds? — It can be scary when blood starts coming out your nose or your child's nose. But nosebleeds are not usually serious. They are very common. The most common causes are dry air and nose-picking.
If you or your child gets a nosebleed, the important thing is to know how to deal with it. With the right care, most nosebleeds stop on their own.
How do I know if a nosebleed is serious? — You should see a doctor or nurse right away if your nosebleed:
Causes blood to gush out of your nose or makes it hard to breathe
Causes you to turn very pale, or makes you tired or confused
Will not stop even after you do the "self-care" steps listed below
Happens right after surgery on your nose, or if you know you have a tumor or other growth in your nose
Happens with other serious symptoms, such as chest pain
Happens after a serious injury, like a car accident or a hard hit in the face
Will not stop, and you take medicines that prevent blood clots, such as warfarin (brand name: Coumadin), clopidogrel (brand name: Plavix), or daily aspirin
If you have chest pain, feel woozy, or if you are bleeding a lot, call for an ambulance (in the US and Canada, dial 9-1-1). Do not drive yourself to the hospital and do not ask someone else to drive you.
Nosebleed self-care — With the right self-care, most nosebleeds stop on their own. Here's what you should do:
1. Blow your nose. This might increase the bleeding for a moment, but that's OK.
2. Sit or stand while bending forward a little at the waist. DO NOT lie down or tilt your head back.
3. Pinch the soft area towards the bottom of your nose, below the bone (picture 1). Do NOT grip the bridge of your nose between your eyes. That will not work. DO NOT press on just 1 side, even if the bleeding is only on 1 side. That will not work either.
4. Squeeze your nose shut for at least 15 minutes. (In children, squeeze for only 5 minutes.) Use a clock to time yourself. Do not release the pressure before the time is up to check if the bleeding has stopped. If you keep checking, you will ruin your chances of getting the bleeding to stop.
If you follow these steps, and your nose keeps bleeding, repeat all the steps once more. Apply pressure for a total of at least 30 minutes (or 10 minutes for children). If you are still bleeding, go to the emergency room or an urgent care clinic.
What if I get repeated nosebleeds? — Frequent nosebleeds can be caused by:
Breathing dry air all the time
Using cold or allergy nasal sprays too much
Frequent colds
Snorting drugs into your nose, such as cocaine
In some cases, repeat nosebleeds can be a sign that your blood does not clot like it should. If that is the case, there are often other clues. For instance, people with clotting problems bruise easily and might bleed more than you would expect after a small cut or scrape.
Nosebleed treatment — If you end up seeing a doctor or nurse for your nosebleed, he or she will make sure you can breathe OK. Then he or she will try to get the bleeding to stop. To do that, he or she might have to put a device or some packing material up your nose.
What can I do to keep from getting nosebleeds? — You can:
Use a humidifier (a machine that makes the air less dry) in your bedroom when you sleep
Keep the inside of your nose moist with a nasal saline spray or gel
Not pick your nose, or at least clip your nails before you do to avoid injury
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15461 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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