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HealthInfo Canterbury

Nosebleeds

Nosebleeds are common, especially in children. They are usually easy to treat and usually don't mean anything is seriously wrong. They can be caused by minor injuries to your nose, irritation from hay fever, a cold, picking your nose, or high pressure (for example, flying in an aeroplane). The medical word for nosebleeds is epistaxis.

A bleeding nose can be more serious in an older person who has other health problems, such as high blood pressure, or who is taking blood-thinning medications such as aspirin and warfarin.

If a child has a bleeding nose, always check to see if there is something stuck in their nose. If there is, visit a doctor straight away. Don't try to take the object out yourself, as you might cause more damage.

Important!

If someone has a bleeding nose or has fluid dripping from their nose after a head injury phone 111 for an ambulance urgently. They may have a fractured (broken) skull.

First aid for nosebleeds

If the bleeding is heavy or doesn't stop within 20 minutes, keep applying pressure to your nose and see a doctor urgently.

Don't blow your nose for a few hours after the bleeding stops, as it might start again. To stop it from bleeding again, avoid hot food, drinks, having a shower, and being in the sun for a couple of days after your nosebleed.

Rest and avoid straining or bending for one or two days after a nose bleed. If you need to sneeze, try to sneeze with your mouth open, to avoid straining your nose.

Frequent nosebleeds

If you or your child have a lot of nosebleeds:

Nasal cauterisation

One treatment for frequent nosebleeds is called nasal cauterisation (cor-ter-iz-ay-shun). This means sealing off the small blood vessels in your nose that are causing the problem. It is done with either silver nitrate, or a process called bipolar diathermy.

Silver nitrate cauterisation can be a bit painful, especially for children. There is also a small chance the process could damage the middle wall between their nostrils (this is called the septum).

After nasal cauterisation

If an ENT doctor (also called an ear, nose and throat specialist, or an otolaryngologist) has cauterised your nose, you may need to have a second treatment to stop the bleeding completely.

You may also have a dressing in your nose – this is also called packing your nose. Sometimes the packing is dissolvable. Ask you doctor whether yours needs to be removed or is designed to stay in. If you have been prescribed antibiotics, make sure you take them all and don't have any left over.

If you have been given an ointment, apply it to the affected nostril two to three times a day, for five to seven days. This will keep the scab soft. Put a small amount of ointment on your fingertip, and put it inside your nostril against the middle wall of your nose. Be careful not to scratch your nose with your fingernail.

Avoid any medicines containing aspirin (Disprin), diclofenac (Voltaren) or ibuprofen (Brufen, Nurofen, Panafen) for a week, unless a doctor tells you to keep taking them.

Tell the doctor about any blood-thinning medicines you are taking. If you are taking warfarin, you will probably have to change the amount you take. Follow the instructions the doctor gives you and arrange a follow-up appointment with your GP.

Written by HealthInfo clinical advisers. Endorsed clinical director, Otolaryngology, Canterbury DHB. December 2015.

Page reference: 47593

Review key: HINBC-16619