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How to stop nose bleeds: causes, treatment and prevention

How to stop nose bleeds

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Complete guide on how to stop nose bleeds outlines the causes, treatment, prevention, when it is dangerous and when to see a doctor.

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Everyone gets a sudden nosebleed occasionally. Medically, a nosebleed is known as epistaxis, and it usually looks more dangerous than it is and simple methods to stop a nose bleed can be used. A nosebleed becomes an emergency if it lasts for 20 minutes. Frequent nosebleeds should also be clarified by an ENT doctor in order to rule out serious illnesses as the cause.

How to stop nose bleeds: immediate help
How to stop nose bleeds: Causes of nosebleeds
Nose bleeds during pregnancy
(Nocturnal) nose bleeds in babies and children
Diagnosis and examinations for nosebleeds
How to stop nose bleeds: best methods
How to stop nose bleeds: Preventing nosebleeds
Stopping Nosebleeds: Top Tips
Stop nosebleeds: what to do?

How to stop nose bleeds: Immediate help

How to stop nose bleeds
  • Sit upright ; if this is not possible, keep your head higher than the rest of your body.
  • To never place head back , but slightly bend forward, for example, over the sink, or let the blood flow into a tissue. Only apply gentle pressure!
  • For cooling the neck care by wet compresses or cold compress!
  • Compress nostrils with light pressure for a few minutes can stop a nosebleed.
  • Do not swallow blood, otherwise there is a risk of nausea, vomiting and swallowing!

Epistaxis should not last longer than 20 minutes (less in children!). Massive blood loss and nosebleeds in connection with head injuries are medical emergencies that must be clarified immediately by a doctor!

Sometimes nasal secretions are also mixed in with the blood. In these cases one speaks of nosebleeds, medically epistaxis. It is triggered by tiny broken veins in the nasal mucous membrane. Although it is often a terrifying symptom, in most cases there is very little blood loss from a nosebleed.

The bleeding itself is mostly not painful . Only the cause of nosebleeds can cause pain, such as a blow on the nose. If blood runs into the throat, it should not be swallowed. Otherwise, you may feel sick and vomit .

How to stop nose bleeds: When to see a doctor?

Nosebleeds are common. It is believed that every second adult will suffer from it at least once in their life, and nosebleeds in children are not uncommon. The causes are very different and mostly harmless. However, nosebleeds can also be the sign of serious internal diseases , such as kidney and cardiovascular diseases. If, for example, high blood pressure (hypertension) is behind the nosebleed, stress occurs as an aggravating factor: If a hypertensive patient is under tension or has to be upset, this is often expressed by nosebleeds.

In rare cases, nosebleeds can indicate leukemia , tumors of the nose and sinuses, the vascular disease Osler’s disease or a disorder of the blood platelets (thrombopathy). In addition, nosebleeds are particularly common in people with bleeding. Frequent, unusually heavy or stress-related nosebleeds should therefore be taken seriously and examined by an ear, nose and throat doctor (ENT doctor).

The emergency doctor should be notified immediately and first aid should be provided, if the nosebleed causes massive blood loss that can sometimes be life-threatening in children. An alarm signal is when the nosebleed is very strong or after 20 minutes (less in children!) It could not be stopped . Then clouding of consciousness and circulatory problems up to fainting can quickly set in. Then an emergency doctor must be called immediately or the emergency room must be visited!

Individual episodes of nosebleeds without accompanying symptoms usually do not require any further clarification by the ENT doctor as long as the bleeding can be stopped within a few minutes.

Causes of nosebleeds are mostly harmless

The nasal mucous membrane is supplied with blood by very fine veins. If one or more of these veins burst, a nosebleed occurs. The triggers for this are mostly local: Too much pressure is applied in the nose. This pressure injures the veins of the nasal lining. Probably the most well-known trigger for nosebleeds is drilling your nose with a finger. Also, excessive sneezing veins of the nasal mucosa can lead to burst.

The nasal mucosa is particularly susceptible if it is severely dried out (e.g. in overheated rooms) or inflamed (as in the case of a cold ). Often the bleeding areas heal poorly: any scab that forms tears off easily and the bleeding recurs. If the symptoms still do not subside, the family doctor or ENT doctor should be consulted to rule out more complex causes of the bleeding to be on the safe side. Medicines such as anticoagulants and certain pain relievers also cause nosebleeds.

How to stop nose bleeds: Possible triggers at a glance:

  • dry nasal mucosa due to heating air
  • Force applied to the nose
  • Cold ( cold ) and hay fever
  • physical or emotional stress
  • Foreign matter in the nose
  • Taking blood-thinning medication (e.g. with the active ingredients acetylsalicylic acid, Marcumar)
  • High blood pressure (hypertension)
  • Vitamin K deficiency
  • Foreign matter in the nose
  • Epistaxis digitorum (“nosebleed from nose picking”)
  • anatomical deviations of the nasal septum
  • Holes in the nasal septum
  • Injuries to the nose, for example fractures
  • chronic inflammation of the sinuses ( sinusitis )
  • Malformation or enlargement of the blood vessels in the lining of the nose
  • Nasal polyps
  • local medication (such as cortisone sprays)
  • Irritants (such as cigarette smoke)
  • sudden changes in the weather
  • rough blowing your nose and blowing your nose
  • Cancer of the nose (rare!)
  • Lack of platelets (thrombocytopenia)
  • Acute lymphocytic leukemia (ALL)
  • severe liver disease (such as cirrhosis of the liver )
  • Bleeding disorder (haemophilia)
  • Platelet dysfunction
  • the rare hereditary disease Osler’s disease
  • Pregnancy

Important to know: nosebleeds are by no means always based on a recognizable cause! In the case of children in particular, this often happens without cause.

Nosebleeds during pregnancy

Women who are pregnant also often complain of nosebleeds. It’s annoying, but not a cause for concern. Frequent nosebleeds are one of the typical pregnancy symptoms. The pregnancy hormones prepare the body for the birth : the blood volume increases, the blood vessels widen, and the blood supply to the mucous membranes and connective tissue is increased.

The nose is often blocked and can bleed more often. Usually the nosebleed subsides after the birth. Until then, the mother-to-be has to be patient. Fortunately, nosebleeds can usually be easily stopped during pregnancy and prevented with gentle measures (more under “Prevention”).

Nosebleeds in children, babies and adolescents

Nosebleeds are also a very common symptom in young children and adolescents. The cause lies in the anatomy of the nose: directly behind the nasal septum is a vascular plexus with a high blood supply, the Kiesselbach plexus (Locus kiesselbachi). It can be injured by violent nose picking as well as by romping or blowing the nose too violently , as often occurs in children.

But allergies, (school) stress or air that is too dry can also trigger the flow of blood from the nose. In the latter case, nosebleeds can also occur unnoticed at night , which can sometimes happen in children. When night bleeding from the nose accumulates, a visit to the pediatrician is called for.

Parents should also see a doctor with their child if the offspring bleeds from the nose repeatedly, for unexplained reasons or unusually heavily. In acute cases, home remedies similar to those used for adults are used, such as a cool, wet washcloth that is placed on the child’s neck.

Nosebleeds in the elderly are often stronger and longer

When older people suffer from nosebleeds, the Kiesselbach braid is hardly to blame. With them, it is due to blood vessels that have become brittle over time when a torrent comes out of the nose.

Therefore, caution is advised here, because corresponding to the injury to a larger vessel, the blood loss is greater and the nosebleed can last longer. If it occurs frequently, a visit to the ENT doctor is also advisable. If the causes of the frequent nosebleeds are unclear, or if an illness is a possible trigger for nosebleeds, investigations are needed. First, the doctor will ask about the medical history (anamnesis). Important details are:

  • Start of bleeding
  • previous bleeding episodes and their treatment
  • further signs of illness
  • Taking medication
  • This information enables the family doctor or ENT doctor to draw conclusions about the development of the current bleeding. It is also important to clarify allergies and susceptibility to dry air.

The doctor will also perform a rhinoscopy (nasoscopy) to identify the source of the nosebleed. An endoscope is inserted into the nose. While this is not painful, it can be uncomfortable. Therefore, local anesthetics can be used.

If the examination by the ENT doctor does not provide any clarification, further specialists will be called in. If nosebleeds from head injuries are suspected, x-rays of the skull should be taken.

Chronic nosebleeds or nosebleeds, which are accompanied by unusual symptoms such as new tissue formation in the nose, persistent general fatigue or susceptibility to bruising, may be an indication of a disease as the cause. In such cases, the doctor will, for example, have a blood analysis carried out in order to draw conclusions about a possible blood formation disorder.

The liver function tests should be monitored if repeated bleeding or stop the individual bleeding a long time and are difficult to stop. The liver makes most of the so-called clotting factors in the blood, which are needed to stop bleeding. Repeated bleeding that is difficult to stop can therefore be an indication of liver disease.

Last but not least, if you have a tendency to nosebleeds, your blood pressure should also be checked, after all, recurrent nosebleeds can also be a symptom of high blood pressure. A critical rise in blood pressure can manifest itself, for example, in a surge of nosebleeds .

How to stop nose bleeds: best methods

In most cases, nosebleeds can be treated on a self-help basis. However, if this does not stop the bleeding, a doctor should be consulted.

  • Sit down leaning forward and let the blood drain off first.
  • If it is not possible to sit upright, raise your head. This lowers the blood pressure in the nasal area.
  • Then gently squeeze your nose (at least ten minutes) while breathing through your mouth.
  • Spitting out blood in the oral cavity.
  • Cold compresses on the neck narrow the blood vessels and help stop bleeding.
  • Tamping with cotton can prevent further blood loss.

For hemostasis, the head should not be in the neck down are concerned and should not lie down because the blood can flow elsewhere in the throat and from there into the stomach (nausea, vomiting), or worse, into the lungs.

If the nose bleeds frequently, the sensitive nasal mucosa can be cared for with a nasal ointment or nasal oil . In addition, there are also special nasal pins for treatment in acute cases, which help close the little miracles and soothe the mucous membrane in the nose.

If the hemostasis does not succeed immediately with these aids and tips, a simple nosebleed can turn into a medical emergency due to ongoing blood loss. In order to be able to estimate the amount of blood lost, it should be collected in a bowl if possible.

Heavy or frequent nosebleeds: what does the doctor do?

In the event of chronic nosebleeds, the ENT doctor is the first point of contact. If the nosebleed is very severe, he will first try to obliterate the broken vein by laser or acid etching. The healing of wounds inside the nose is supported with an ointment .

If this is unsuccessful, a nasal packing is used: it is inserted into both nostrils in order to compress the blood vessels on all sides and thereby stop the bleeding. The tamping is removed after a few hours or days.

For tamponades that are placed in the back of the nose and throat, an antibiotic can be prescribed to help prevent infections. Vascular contracting drugs are also sometimes injected into the tissue at the source of the bleeding.

If the bleeding cannot be stopped in this way, it is possible to tie off the blood vessels with a clip, for example . In rare cases, chronic nosebleeds need surgery to be corrected.

According to studies, a doctor can stop severe nosebleeds with a hot nasal shower . Experts observed that within ten minutes of being treated with water at 50 degrees Celsius, the nosebleed usually stops. So far, however, this has not been a common practice for treating nosebleeds.
If, for example, internal diseases cause nosebleeds, targeted treatment is also sought in addition to the measures mentioned.

How to stop nose bleeds: preventing nose bleeds

Nosebleeds are usually harmless. To prevent this, it is usually sufficient to refrain from picking your nose or blowing your nose violently. If medication has caused the nosebleed, you should avoid or change it after consulting your doctor. Never discontinue blood-thinning agents like Marcumar yourself!

In the winter months, heated air dries out the mucous membranes. It is therefore advisable to ensure that there is sufficient humidity in the interior, for example through heating evaporators, indoor fountains or potted plants and regular ventilation.

Mild nasal ointments and oils that are as fat-free as possible , which are available over the counter in pharmacies and drugstores, but also household remedies such as occasional nasal rinses or inhalation with the help of saline solutions keep sensitive nasal mucous membranes supple. In this way, crusts in the nose (caused by a cold or previous nosebleed) are gently dissolved without the nose starting to bleed again.

Nasal sprays and drops should only be used for a short time if the nose is blocked, as these agents can irritate and dry out the nasal mucous membrane over time. It is also important to drink enough to ensure that the mucous membranes are moistened, around one and a half to two liters of water a day.