The nose has a rich supply of blood vessels which help to warm the air we breathe into our lungs.  This rich plexus of blood vessels (called the Little’s area) is fragile and can be easily damaged resulting in a nose bleed.

Risk factors

• Dry air environment
• Injury to the nose
• Frequent nose picking
• Blowing your nose too hard or sneezing too hard
• Chemical irritants
• Hypertension
• Blood thinning medication (like Aspirin, Cardiprin, Plavix or Warfarin)
• Blood disorders such as leukaemia or haemophilia
• Chemotherapy during cancer treatment
• Nasal infection
• Nasal polyp, tumours or cancer

Click to view StJohnAmbulance video on Nose Bleed

Self-Treatment

Step 1. Sit down and firmly pinch your nose just above the nostrils for 10-15 minutes.

Step 2. Lean forward and breathe through your mouth so that the blood does not flow back into your throat.

Step 3. Apply a cold ice pack (or a bag of frozen vegetables) wrapped with a soft towel to your bridge of your nose or forehead.  You can also put 1-2 ice cubes in your mouth.

Credit: GeelongMedicalGroup

Most nose bleeds resolve by following above steps.  However, see your doctor IF the bleeding;

• persists beyond 20-30 minutes.
• is caused by injury.
• making you feel faint or difficult to breathe.
• is caused by your blood thinning medication.

Treatment

Nose packing by your doctor

If the nosebleed does not stop, your doctor will need to pack your nose with gauze and medication or with customised nasal packs.  In severe cases, your doctor may need to use a balloon catheter to be inflated in your nose to stop the bleeding.

Nasal Cautery

Nasal cautery is done using either chemical or diathermy (heat) introduced through an endoscope by your ENT doctor under local anaesthesia.  In children, this procedure may need to be done under general anaesthesia (with the child asleep).

Diagnostic Tests (may be necessary for recurrent nose bleeds)

• Blood tests to check your haemoglobin and clotting time.
• Endoscopy of your nose and nasal passage
• X-ray or CT scan of your head and neck (in severe cases or causes of injury)

Prevention Do’s and Don’ts

DO drink lots of water to stay hydrated daily.

DO use a humidifier in your room.

DO NOT pick your nose.

DO NOT blow your nose too hard.

See your ENT doctor if you have recurrent nose bleeds.

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