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Nose Bleed

When to call the doctor

  • Repeated episodes of nosebleeds
  • Additional bleeding from places other than the nose, such as in the urine or stool
  • Bruising easily
  • If you are on any blood-thinning medications, including aspirin or warfare (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

When to go to the hospital

  • 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 spitting 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.

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Self-Care at Home

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.

How 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.

What to do after the bleeding has stopped

  • Once 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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Follow-up

Most people can be seen and discharged from a doctor's office or the hospital's emergency department after treatment for a nosebleed. If nasal packing has been placed, do not try to remove the packing yourself. You need to be seen again, usually within 1-3 days, at which time the packing will be removed.

Try to avoid any further irritation of the nose. Do not blow your nose. Try not to sneeze or cough, if possible. Avoid any strenuous activities, such as heavy lifting or exercise.

If possible, try not to take any medications that may interfere with normal blood clotting. These medications include aspirin or anti-inflammatory drugs such as ibuprofen (Motrin or Advil) or naproxen (Aleve or Naprosyn). If you take these medications for a chronic medical condition, consult with your doctor about to what to do. Acetaminophen (Tylenol) can be taken for fever or pain.

Prevention

Most nosebleeds occur during the winter in cold, dry climates. If you are prone to nosebleeds, use a humidifier in your home. Use petroleum jelly (Vaseline) or a saline nasal spray to keep your nasal passages moist.

Avoid picking your nose or blowing your nose too vigorously.

If the nosebleed is related to another medical condition, such as liver disease or a chronic sinus condition, follow your doctor's instructions to keep that problem under control.

Outlook

With proper treatment, people recover from nosebleeds with no long-term effects.

If another undiagnosed disease is causing the bleeding, the prognosis depends on discovering and treating that disease.

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