Nosebleeds

Patient Information Leaflet

Introduction

This leaflet is for people who have had a nosebleed. This is known medically as epistaxis. It gives information on what causes nosebleeds and how they are treated.

What causes nosebleeds?

Inside of your nose is full of tiny blood vessels that can become damaged and bleed quite easily.

Common causes of nosebleeds include:

• Picking your nose.
• Blowing your nose very hard.
• A minor injury to your nose.
• Changes in temperature or infections, such as the common cold, can sometimes cause the inside of the nose to become dry and cracked.
• Using nasal decongestants more than recommended in the instructions.

Occasionally, bleeding can come from the blood vessels deeper within the nose. This can be caused by a blow to the head, recent surgery on the nose and hardened arteries (atherosclerosis).

Are nosebleeds serious?

Nosebleeds are not usually serious. However, occasionally the bleeding can be so heavy that it goes into back of nose and down into throat, producing clots. When this occurs, it is very important to slow/stop the bleeding (described in the section ‘How are they treated’) and go to the nearest emergency department.

How are they treated?

To stop a nosebleed:

• Sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10 to 15 minutes.
• Lean forward and breathe through your mouth. This will make sure blood drains down your nose instead of down the back of your throat.
• Place an ice pack or bag of frozen vegetables covered by a towel on the bridge of your nose.
• Stay upright, rather than lying down. This will reduce the chance of blood going down the back of nose into the throat.
• Do not put anything in your nose to stop the bleeding e.g. cotton wool. It will not work and may start the bleeding again when removing it.

If the bleeding eventually stops, you will not usually need medical treatment. However, in some cases you may need further treatment from your GP or in hospital.

When do I need medical treatment?

Contact your GP or call NHS 111 if:

• The bleeding does not stop and you are taking a blood-thinning medicine (anticoagulant) such as warfarin, or have a clotting disorder such as haemophilia.
• You have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion.
• A child under two years of age has a nosebleed.
• You have nosebleeds regularly.

Go to your nearest emergency department (A&E) if:

• The bleeding carries on for longer than 20 minutes.
• The bleeding is heavy and you have lost a lot of blood.
• You have blood passing into the back of your nose which is flowing into your throat.
• You swallow a large amount of blood that makes you vomit (be sick).
• The nosebleed started after a serious injury, such as a car crash.

How do I care for myself at home?

Things you can do to prevent nosebleeds include:

• Avoid picking your nose and keep your fingernails short.
• Blow your nose as little as possible and only very gently.
• Regularly apply petroleum jelly (such as Vaseline) to the inside of your nostrils to keep the inside of your nose moist.
• Wear a head guard during activities in which your nose or head could get injured.
• Always follow the instructions that come with nasal decongestants.

Please note that if you have frequent or heavy nosebleeds, you should get a check-up with your GP as it may mean you have a more serious health problem, such as high blood pressure or a blood clotting disorder.

A lot of bleeding over a long period of time can also lead to further problems such as anaemia.

Follow-up care

When you leave the Emergency Department, the healthcare practitioner will tell you whether you need to see your GP, an ENT specialist or whether you do not need any follow-up care.

If your GP thinks you have a more serious problem that is causing your nosebleeds, he/she may refer you to an ear, nose and throat (ENT) specialist for further tests.

Can I find out more?

You can find out more from the following weblink:

NHS Choices

http://www.nhs.uk/conditions/Nosebleed/Pages/Introduction.aspx

If you have any questions, or if there is anything you do not understand about this leaflet, please speak to one of our nurses. If you need help when you return home, please contact your GP.

If you have any feedback on this patient information leaflet, please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Joanne Taylor Date reviewed: July 2024 Next review due: August 2026 Version: 5 DGH ref: DGH/PIL/01346