Patient Information - Epistaxis (Nose bleeds)
Epistaxis (Nose bleeds)
Patient information leaflet
Emergency Department
Darent Valley Hospital
Darenth Wood Road
Dartford
Kent
DA2 8DA
01322 428100
Author: Dr Stephanie Soyombo
Title: Emergency Department Doctor
Information accurate at time of going to print.
What is a nosebleed?
Epistaxis is the medical word for bleeding from the nose. The common site for a nosebleed is to start in the ‘Little’s area’. This is just inside the entrance of the nostril, on the nasal septum (the middle part of the nostril). The blood vessels here are quite fragile and can easily rupture, for no apparent reason.
Causes of nosebleeds
- If you pick your nose
- If you have a cold or blocked stuffy nose from something like hayfever
- When you blow your nose
- Changes in temperature
- Minor injuries to the nose
In most cases, the bleeding may only last a short time and is usually easy to control. The bleeding may be more prolonged and harder to stop if you have: high blood pressure, heart failure, a blood clotting disorder, or are taking 'blood thinning' drugs (anticoagulants) such as Warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban or Clopidogrel, Ticagrelor.
Treatment for a nosebleed
Sitting forward with your mouth open and spit out any blood – try not to swallow blood as it will irritate your stomach and make you feel sick.
- Pinch hard the fleshy/flexible part of your nose. It is useless to put pressure over the root of your nose or nose bones.
- Apply an ice pack over the bony bridge part of your nose (a pack of frozen peas may be used) and suck an ice cube. The cold helps the blood vessels to constrict (become narrow) and stop bleeding.
- Try to remain calm and rest quietly.
- If after 20 minutes it has not stopped, seek medical advice.
Treatment in hospital
Nasal cautery
If the bleeding continues, your doctor may use a cautery stick, essentially a cotton bud with silver nitrate on the tip. If the doctor can identify the bleeding point, they will use the cautery stick to seal the area of bleeding and you will be able to go home. Use of the stick may sting for a moment. If nasal cautery is not successful, we may need to admit you for further treatment.
Nasal packing
Your nose may require packing, with a sponge or a ribbon dressing (a soft absorbent device into a nostril), to stop the bleeding. If it is severe you may need packing with an epistaxis balloon. The packing will completely block your nose and you will need to breathe through your mouth.
If your nose is packed, this will remain in place for 24 to 48 hours. Since your nostril will be blocked you may experience: a mild headache, dry mouth, reduced appetite, reduced taste sensation, difficulty swallowing, or watery eyes. We may be able to discharge you home with an ENT clinic appointment but it may be necessary to admit you for further treatment.
Discharge advice
You should take the following precautions for at least two to three days after a nosebleed, or until after all the bloodstained discharge has stopped.
- Avoid very hot or cold drinks.
- Avoid hot baths or showers.
- Do not blow your nose - sniff gently instead.
- Do not pick your nose. A small scab will form and it should not be disturbed.
- If you need to sneeze, do so with your mouth open.
- Avoid any strenuous activity.
- Avoid smoking, smoky atmospheres and drinking alcohol.
Further Support
For general medical advice please use the NHS website, the NHS 111 service, walk-incentres, or your GP.
NHS website provides online health information and guidance at www.nhs.uk
This leaflet has been developed in partnership with the Patient Information Group and our DGT Patient Partners
Patient Information
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Reference Number: 05
First published: Last Reviewed: Next review date:
July 2024 June 2024 July 2026