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.
Medical Treatment for Nosebleeds
- A minor nosebleed that has stopped may require no treatment at all. Frequently, the body will form a clot at the site of the bleeding that stops any further bleeding.
- If the source of the bleeding is a blood vessel that is easily seen, a doctor may cauterize it (seal the blood vessel) with a chemical called silver nitrate. Cauterization is most effective when the bleeding is coming from the very front part of the nose.
- In more complicated cases, a nasal packing may be required to stop the bleeding. The idea behind this is to put pressure from inside the nostril to halt the bleeding. Many different types of packings are available, ranging from petroleum (Vaseline) gauze to balloon packs to synthetic sponge packs that expand when moistened. The decision as to which one to use is usually made by the doctor.
- Most people who receive an anterior nasal packing go home with it in place. Because these packings block the drainage pathways of the sinuses, antibiotics may be started to prevent a sinus infection. The packing is usually left in for 24-72 hours.
- A posterior nosebleed that does not stop bleeding on its own requires admission to the hospital. A posterior nasal packing is required. Different types of packings are available, though a balloon pack is most commonly used.
- Unlike the anterior nasal packings, posterior nasal packings are very uncomfortable and frequently require sedatives and pain medications. Complications can be associated with these packs, including infection and blockage of the breathing passages. Admission to the hospital and close monitoring are required.
- Posterior packings are usually left in place for 48 to 72 hours. If this does not stop the bleeding, surgical or radiologic procedures can be performed.