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Nosebleeds

When to Seek Medical Care for a Nosebleed

When to call the doctor about nosebleeds:

  • If you have repeated episodes of nosebleeds
  • If you have additional bleeding from places other than the nose, such as in the urine or stool
  • If you bruise easily
  • If you are on any blood-thinning drugs, including aspirin or warfarin (Coumadin)
  • If you have any underlying disease that may affect your blood clotting, such as liver disease, kidney disease, or hemophilia (inability of blood to clot)
  • If you recently had chemotherapy

Go to the hospital for nosebleeds if:

  • You are still bleeding after pinching the nose for 10 minutes.
  • You are having repeated episodes of nosebleeds over a short time.
  • You feel dizzy or light-headed or like you are going to pass out.
  • You have a rapid heartbeat or trouble breathing.
  • You are coughing up or vomiting blood.
  • You have a rash or temperature greater than than 101.4°F (38.5°C).
  • Your doctor instructs you to go to a hospital's emergency department.

Nosebleed Exams and Tests

  • To examine the nose, the doctor places medications into the nostrils, usually with a cotton ball, that numb the inside of the nose as well as constrict the blood vessels in that area. This will also reduce swelling and allow the doctor to see inside the nose better
  • The diagnosis of a posterior nosebleed is usually made when attempts to control the bleeding when the measures used for an anterior nosebleed have failed. Seeing the source of a posterior nosebleed is nearly impossible.
  • Lab tests may be done to evaluate blood loss or the effects of blood thinning drugs.

Home Treatment for Nosebleeds

A small amount of bleeding from a nosebleed requires little intervention. A common scenario is when a person with a cold or a sinus infection blows his or her nose vigorously and notices some blood in the tissue. Avoiding any more vigorous nose blowing, sneezing, or nose picking is usually enough to keep the bleeding from getting worse.

  • To stop a nosebleed:
    • Remain calm.
    • Sit up straight.
    • Lean your head forward. Tilting your head back will only cause you to swallow the blood.
    • Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier.
    • Spit out any blood in your mouth. Swallowing it may make you vomit.
  • After the bleeding has stopped:
    • Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours.
    • Ice packs do not help.
    • Exposure to dry air, such as in a heated home in the winter, can contribute to the problem. Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.

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