A nosebleed can often be handled safely by the patient or caregiver. A severe nosebleed that does not respond to first aid requires medical management.
Factors affecting outcome:
(1) presence and severity of any underlying coagulation defect (thrombocytopenia, anticoagulation, liver disease, etc.)
(2) precipitating cause (such as trauma) vs spontaneous
(3) severity of the bleeding
(1) Sit calmly in a chair with the head forward.
(2) Keep the mouth open to let blood and clots to drain out.
(3) Squeeze both sides of the lower nose firmly together for 10-15 minutes.
(4) Place a cold cloth or ice against the nose and midface to induce vasoconstriction.
(5) If bleeding is controlled avoid activity for at least an hour to reduce the chances of a rebleed.
(1) Do not lean the head back if the bleeding is brisk. This can result in choking or clots obstructing the airway.
(2) Do not put a plug in the nose or block the nostrils.
(3) Do not irritate the nose.
If bleeding persists despite reasonable attempts at control then seek medical care. Medical evaluation will probably be necessary if there is an underlying coagulopathy or the bleed was caused by significant trauma.
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Purpose: To provide first aid to a person with a nosebleed.
Specialty: Otolaryngology, Hematology Oncology