Nosebleeds – Epistaxis

Questions

  • Does your nose bleed from one side or both sides?
  • Does it take longer than 5 minutes to stop the bleeding?
  • Are you able to stop the bleeding by pinching your nose?
  • Have you had injury to your nose?
  • Have you had to go to the ER for nosebleeds?
  • Have you had to have your nose packed?
  • Have you had to have your nose cauterized?
  • Do you take any blood thinners?
  • Do you have high blood pressure?

 

Related Topics

 

Links

About Nosebleeds

Anterior nosebleeds originate from the front of the nose and cause a flow of blood out of one or both nostrils. Posterior nosebleeds originate in the back of the nose and the blood flows down the back of the mouth and throat. 

 

Do’s and Don’ts

  • Keep your head elevated above the level of your heart. Squat, don’t bend forward.
  • Wipe only, do not touch or pick the inside of your nose or you may remove a scab and restart bleeding.
  • Do not blow your nose until you’ve had 1 week of no bleeding. Blowing can blow off the scab and start a nosebleed
  • Sneeze with your mouth open to keep the pressure off of your nose
  • Avoid strenuous activity or anxiety-producing activities for 2 weeks. No heavy lifting or straining
  • Do NOT remove any packing placed by a doctor
  • Keep your blood pressure under control
  • Avoid blood thinning products: Aspirin, Ibuprofen, Coumadin/Warfarin, Eliquis, Plavix/Clopidogrel, Heparin, Vitamin E and seaweed.
  • Avoid hot liquids until 1 week of no bleeding
  • Avoid hot bub baths, hot showers and Jacuzzis
  • Do not drink alcohol until you have had 2 weeks of no bleeding
  • Avoid drying substances like alcohol, caffeine, decongestants and antihistamines
  • Moisturize your nose with nasal saline every few hours but don’t blow, just wipe

 

Solutions

  • If your nose is actively bleeding…
  1. Sit up, do not tilt your head back or blood will drain into your throat.
  2. Try to remain as calm as possible
  3. Spray the nose with Afrin nose spray (oxymetazoline is the active ingredient)
  4. Firmly pinch the soft part of your nose between the tip and the top a full 5 minutes while you breathe through your mouth
  5. Place a bag of crushed ice or frozen peas over your nose
  • If these measures do not stop the bleeding, go the nearest Emergency Room for treatment
  • If the bleeding stops but keeps coming back, make an appointment at Beach Cities ENTs
  • Treatment options include
    • All the conservative measures listed under Do’s and Don’ts
    • Cautery is used to burn the bleeding area with silver nitrate or an electric current in order to stop the bleeding
    • Packing involves putting pressure on the bleeding area using a sponge, gauze or an inflatable balloon