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Nosebleed control and treatment tips

Updated November 18, 2015

The nose filters, humidifies, and warms air as it passes through the nose, mouth, and into the trachea. The nose is a combination of soft tissue, cartilage, and bone. It is rich with arterial blood vessels with forward flow, progressively warming incoming air. If the nose is physically traumatized, the underlying facial bones responsible for nose, skull, and eye formation may become injured as well.

Most nosebleeds are known as anterior nosebleeds and occur in the front (anterior) of the nose. Facial trauma, falls, collisions, nose picking, and irritation from a foreign body or cold air are some known causes of this type of nosebleed. Anterior nosebleeds typically involve only one nostril, with blood visibly draining out of the nasal openings.

Posterior nosebleeds are less common and are generally derived from an arterial source from the back (posterior) of the nasal cavity. Posterior bleeding usually drains into the mouth, frequently causing the affected individual to spit or swallow blood. If swallowed, the blood can either obstruct the upper airway or induce vomiting.

General treatment for any nosebleed:

  1. Blow nose to remove any poorly formed clots.
  2. Apply well-aimed direct pressure by firmly pinching the nose with thumb and pointer finger.
  3. Lean forward to minimize swallowing blood.
  4. Spit blood out of mouth.
  5. Do not let the patient swallow blood, as it is very irritating to the stomach.
  6. Maintain pressure for 10-15 minutes before inspecting.

Applying ice to the upper lip or neck has little or no effect on blood flow. Focus treatment on well-aimed direct pressure and keeping the airway free of blood.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.
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