Epistaxis, or bleeding from the nose, is a common complaint among our ENT patients here in Anchorage. It is rarely life-threatening but may cause significant concerns, especially among parents of small children. Almost every person has had at least 1 nosebleed in his or her lifetime. Most nosebleeds are benign, self-limiting, and spontaneous, but some can be recurrent.
There are 2 main types of nosebleed, and 1 can be more serious than the other.
- The first type is caused by an anterior nasal blood vessel rupture. This type of nosebleed originates toward the front of the nose and causes blood to flow out through the nostrils. This is the most common type of nosebleed, and it is not usually serious.
- The second type happens in posterior area of the nose, which is more common in the elderly and must be taken seriously. This type of nosebleed originates toward the back of the nasal passage, near the throat. Posterior nosebleeds are less common than anterior bleeds. Children do not usually get posterior nosebleeds.
The inside of the nose has a lot of blood vessels that are close to the surface, so it’s easy for them to get irritated or injured. Most nosebleeds are caused by nothing more than irritation from dry or cold air, or by injury caused by nose-picking. If you take medication to prevent blood clots, you are more likely to get nosebleeds and to have trouble stopping a nosebleed once it starts. Some examples of medications that can cause these problems are warfarin (COUMADIN®), clopidogrel (Plavix®), and daily aspirin use.
If you get nosebleeds frequently, use a humidifier in your bedroom while sleeping, especially if the air is very dry. Keep your nose moist using a saline nasal spray or gel, or by applying Vaseline®.
How to Stop a Nosebleed
Sit up straight and tip your head slightly forward. Note: Tilting your head back may cause blood to run down the back of your throat, which may irritate your stomach and cause vomiting.
Spray the nose with a medicated nasal spray, such as Afrin®, before applying pressure. Use your thumb and forefinger to firmly pinch the soft part of your nose shut. (The nose consists of a hard, bony part and a softer part made of cartilage.)
You may apply an icepack to your nose and cheeks. Cold will constrict the blood vessels and help stop the bleeding. Keep pinching for a full 10 minutes. Check to see if your nose is still bleeding after 10 minutes. Most nosebleeds will stop after 10 to 20 minutes of direct pressure.
Then apply a thin layer of Vaseline or saline nasal spray or gel inside your nose. Do not blow your nose or put anything else inside your nose for at least 12 hours.
If any of these are true, seek medical care through your primary care physician or an emergency room:
- You cannot stop the bleeding after more than 15 to 20 minutes of applying direct pressure.
- You experience repeated episodes of bleeding.
- The bleeding is rapid or the blood loss is large (exceeds a cup of coffee).
- You feel week or faint.
- The bleeding was caused by an injury, such as a fall or other blow to the nose or face.
Here at the Alaska Center for Ear, Nose and Throat in Anchorage, our otolaryngologists are well versed in conditions of the nose. If you’re experiencing a chronic problem with your nasal passageways, you can request a consultation online or get in touch with us via phone at (907) 279-8800.