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This information sheet has been given to you by Paramedics because they have treated you for a nosebleed (also called epistaxis). It contains important information on how to look after yourself and what to do if your condition changes.

Key messages

• Nosebleeds are common and rarely dangerous.
• Most nosebleeds can be managed at home with simple first aid.

What is a nosebleed?

Nosebleeds are very common. They can occur at any age but are twice as common in children. Most nosebleeds are harmless and do not require treatment.

The lining of the nose has lots of tiny blood vessels, which warm the air as it enters the nose. This lining is very fragile and may break easily, resulting in bleeding. Nosebleeds usually occur when one of these small blood vessels bursts.

What causes a nosebleed?

A range of factors can cause a nosebleed. The common ones include:

• fragile blood vessels that bleed easily, mostly in warm and hot, dry weather
• an infection of the lining of the nostrils, sinuses or adenoids
• colds, flu, allergies or hay fever
• bumps or falls
• an object pushed up the nostril
• nose-picking
• constipation causing straining
• medications such as warfarin, aspirin, clopidogrel (also known as ‘blood thinners’) or anti-inflammatory tablets such as ibuprofen
• high blood pressure
• a bleeding or clotting disorder. This is rare.

First aid

You can stop nearly all nosebleeds yourself at home. Follow these simple first aid steps:

• Stay calm.
• If a child has a nosebleed reassure them. Crying increases blood flow and will make the bleeding worse.
• Sit upright and bend forward slightly. Use the thumb and forefinger to pinch the nose. Squeeze firmly over the soft part of the nose just above the nostrils. Hold for 15 minutes and then release the grip slowly. You may have to repeat this step until the bleeding stops.
• Do not keep checking whether the bleeding has stopped. The blood needs time to clot.
• Do not blow your nose once the bleeding has stopped – this may cause it to bleed again.
• Breathe through your mouth while the nostrils are pinched.
• Spit out any blood that comes into your mouth. Do not swallow the blood.
• It may help to put a cold pack or cold cloth over your forehead or the bridge of the nose or the back of the neck.

Home care

• Rest quietly for the next 12 to 24 hours.
• Avoid hot liquids for at least 24 hours after a nosebleed.
• Do not pick or blow your nose for 12 hours.
• Avoid strenuous exercise, straining or lifting heavy items for seven days.
• If you have constipation, ask your doctor or pharmacist for a stool softener to prevent straining.
• Avoid aspirin if possible. If your doctor has prescribed aspirin for a specific condition, ask your doctor what you can do to prevent nosebleeds.
• Some people with dry skin in the nose may find ointment (such as Vaseline) or nasal sprays may help. Ask your doctor or pharmacist for advice.

What to expect

• Most nosebleeds only cause minor discomfort.
• Some people may have several nosebleeds over a period of a few weeks.
• It is very rare to lose a dangerous amount of blood from a nose bleed.
• In the elderly, the bleeding can come from the back of the nose and can be serious. If bleeding doesn’t stop after the above first aid methods have been applied, and/or if the patient becomes dizzy and/or pale, call 000.

Prevention

If the bleeding happens often, ask your local doctor to check for any underlying causes. You may need cautery (a tool which ‘burns’ or ‘freezes’ the blood vessel) to stop the nosebleeds for good. This is only appropriate if a single blood vessel is involved. If there are more, then the bleeding is likely to return. If an ongoing infection is the cause, your doctor may prescribe an antibiotic ointment or tablet.

Other measures that may help prevent nosebleeds include:

• using a humidifier
• drinking plenty of fluids
• using an ointment on the affected area (such as Vaseline)
• using a saline nasal spray
• using headgear when playing sports
• avoiding cigarette smoke.

Seeking help

Call Virtual Emergency Department, see your local doctor or call the ambulance on triple zero (000) if you have followed the above first aid advice and bleeding persists.

Discuss with your local doctor if you have had a nosebleed and are on anti-coagulant medication, you are under the care of a Haematologist or you are being investigated or treated for any blood or cancer-related condition. You may require a blood test. Do not independently stop taking your anti-coagulants without consulting your local doctor first.

Victorian Virtual Emergency Department (VVED) is also available to treat non-life-threatening emergencies. You will be connected to emergency doctors and nurses who will provide medical advice. Please note you will need a device (mobile phone, tablet, computer) with a camera to use this service.

Contact VVED through the website vved.org.au. If you experience issues, please call 9485 9070

Want to know more?

• Ask your local doctor or health care professional.
• Visit the Better Health Channel www.betterhealth.vic.gov.au

Ambulance Victoria is a critical link in Victoria's healthcare system. We welcome your comments as they assist us to improve our services. If you wish to provide feedback, please contact Patient Experience and Consumer Participation Department either via patientexperience@ambulance.vic.gov.au or telephone 1800 875 137.