ENT specialist
Nosebleed: what to do and how to prevent it
What to do if your nose bleeds: the right position, how and how long to pinch, how to prevent more nosebleeds and when to go to A&E. Clear, safe steps.
A nosebleed, or epistaxis, is very common: according to the 2020 US guideline, at least 60 % of people have one at some point, and only about 6 % of them need medical attention. It almost always starts at the front of the nose and can be stopped at home with a simple technique. We explain how, and when to ask for help.
What are these measures for?
Pinching the nose firmly presses on the bleeding vessels and lets a clot form. Leaning forward stops you swallowing blood, which causes nausea.
Before you start
- Stay calm: most nosebleeds stop this way.
- Have tissues, a bowl and a clock to hand.
- Do not put anything inside your nose.
How to do it
- Sit down and lean slightly forward. Do not tilt your head back or lie down.
- Blow your nose gently once to clear any clots.
- Pinch the soft part of your nose firmly, just below the bone, closing both nostrils.
- Breathe through your mouth and spit out any blood; do not swallow it.
- Keep up the pressure for at least 5 minutes without letting go, watching the clock. Do not release to check.
- Let go slowly. If it is still bleeding, pinch again for another 5 minutes or more.
Routine
| Routine | What to do |
|---|---|
| How often | At every nosebleed |
| For how long | At least 5 minutes of continuous pressure; if it is still bleeding, repeat |
| When to stop | When the bleeding stops. If it has not stopped after about 20 minutes of correct pressure, go to A&E |
For the next 24-48 hours, avoid blowing your nose hard, straining and very hot drinks.
Always follow the routine your doctor gave you, which may be different.
Common mistakes
- Tilting your head back or lying down.
- Pinching the hard part (the bone) instead of the soft part.
- Letting go every so often to look.
- Putting cotton wool or products into the nose, including hydrogen peroxide.
- Stopping your blood-thinning medication on your own.
What is normal and when to seek advice
In the following days it is normal to see traces of blood or small scabs.
Call 112 (in Spain) or your local emergency number, or go to A&E, if:
- It has not stopped after about 20 minutes of correct pressure.
- The bleeding is heavy, or you feel dizzy, weak, pale or short of breath.
- You vomit a lot of blood.
- It follows a hard blow to the face or head.
Book an appointment with us if:
- The nosebleeds keep coming back.
- You take blood-thinning medicines and bleed often.
- You always bleed from the same side and also have a blocked nose.
- You bruise easily.
Prevention
- Keep your nails short and avoid picking your nose.
- Blow your nose gently, one nostril at a time.
- If the air is dry, use a humidifier or a continuous-mist seawater spray. Avoid syringe rinses.
- If you get crusts, apply a little petroleum jelly just inside the nostrils.
- Avoid tobacco smoke and strong irritants.
Frequently asked questions
Is it dangerous if I take blood thinners or aspirin? You will bleed more easily, but these measures still work. Do not stop your medication without talking to your doctor.
Does high blood pressure cause nosebleeds? It has not been shown to cause them directly. If you feel unwell, seek advice.
My child gets frequent nosebleeds. Is it serious? Usually not; it is often due to picking or dry air. See us if they keep coming back, are heavy or your child bruises easily.
References
For general information only. It does not replace a medical consultation and cannot be used for diagnosis. In an emergency in Spain, call 112.