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Nosebleed First Aid: How to Stop a Bleeding Nose (Epistaxis)

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Nosebleed first aid starts with staying calm. Blood can look alarming when it pours from someone’s face and even a small break can produce what seems like a serious amount of bleeding. The good news is that most nosebleeds stop within 10 to 20 minutes when handled correctly.

Causes of Nosebleeds

A bump or blow to the face is an obvious cause of bleeding from the nose, but many nosebleeds start without any injury at all. Here are the most common causes of nosebleeds:

Dry air is the leading cause of nosebleeds outside of injuries. Heated indoor air during winter months or living in a dry climate dries out the nasal membrane, causing it to crack and crust. These crusts may itch, and when you scratch or pick at them, the small blood vessels break and start bleeding.

Forceful nose blowing can rupture tiny blood vessels, particularly when you have a cold or allergies that cause repeated blowing.

Colds, allergies and sinus infections inflame the nasal passages. The combination of swelling, increased mucus, and frequent blowing or rubbing creates the conditions for a nosebleed to start.

A deviated septum occurs when the wall between the nostrils sits off-centre. This uneven airflow can dry out one side of the nose more than the other, making that nostril more prone to bleeding.

Nasal sprays used for colds or allergies can dry out and irritate the nasal membranes when overused.

Environmental irritants like cigarette smoke, chemical fumes, and air pollution can damage the delicate nasal lining over time.

Bleeding disorders such as haemophilia or von Willebrand disease can cause blood vessels in the nose to bleed more freely and for longer periods.

Nosebleed First Aid

nose bleed man and injury closeup on sport field

Most anterior nosebleeds (those that start in the front of the nose) will stop with simple nosebleed first aid steps you can do at home.

Step 1: Sit upright and lean forward

Have the person sit down in a comfortable position. Keep their head above the heart by remaining upright. Lean forward slightly so blood drains out of the nose rather than down the throat.

Step 2: Pinch the soft part of the nose

Use your thumb and index finger to pinch the nose shut. Apply gentle pressure to the fleshy area below the bony bridge for around 10 minutes. After which, check and repeat if needed.

Step 3: Rest and avoid irritation

Once the nosebleed stops, avoid blowing, rubbing, or picking at the nose for at least 24 hours. Also avoid hot drinks, hot food, hot showers, and baths for at least 24 hours as heat causes blood vessels to dilate, which can restart the bleeding. Bending over, heavy lifting, or strenuous activity can also increase blood pressure to the nose and trigger re-bleeding. 

When to seek medical attention

Forgo nosebleed first aid and call an ambulance or go to the hospital emergency department if:

  • The bleeding does not stop after 20 minutes of applying pressure
  • If nosebleeds happen more than once a week
  • The nosebleed follows a serious injury to the head or face
  • The person feels faint, dizzy, or weak
  • The person has difficulty breathing
  • If the bleeding is severe and gushing
  • The person is taking blood-thinning medication
  • Unexplained nosebleeds in children under 2 years old

What NOT To Do

man suffering from nosebleed or epistaxis and usin

Many common responses to nosebleeds can actually make the bleeding worse or create new problems. Here is what to avoid when providing nosebleed first aid:

Do not tilt the head back. When you tilt your head back, blood flows down the throat instead of out the nose. Blood that is swallowed irritates the stomach and can cause nausea, gagging, or vomiting. Blood can also enter the airway and cause choking.

Do not lie down. The same principle applies here. Blood will pool in the throat rather than draining safely out of the nose.

Do not stuff tissues, cotton, or tampons into the nostril. Packing the nose with household materials can irritate the already damaged blood vessels and make the bleeding worse. These materials also stick to the clot and can pull it away when removed, causing the nosebleed to start again.

Do not blow your nose. After a nosebleed starts, blowing will dislodge any forming clots and increase bleeding. 

Do not pick at scabs or crusts that form inside the nose. These crusts are part of the healing process. If you disturb them, you can reopen the wound and cause fresh bleeding.

Preventing Nose Bleeding

Woman using nasal spray on light blue background

While you cannot prevent every nosebleed, several measures can reduce how often they occur, and thus how often you need to perform nosebleed first aid.

Keep the nasal lining moist. Use a saline nasal spray two to three times daily to prevent the inside of the nose from drying out. However, overuse of these products can dry out and irritate nasal membranes.

Use a humidifier. Run a cool-mist humidifier in your bedroom, particularly during winter when indoor heating dries the air. 

Avoid picking and rubbing. Teach children not to pick their noses, and keep their fingernails trimmed short to minimise damage if they do.

Blow gently. When you need to clear your nose, blow softly through an open mouth rather than forcefully through closed nostrils. Always sneeze with your mouth open and into a tissue or your elbow.

Quit smoking. Tobacco smoke dries and irritates the nasal lining.

Wear protective equipment. During sports or activities that pose a risk of facial injury, wear appropriate helmets or face guards to protect the nose from trauma.

Learn First Aid For Nosebleeds and More

Nosebleeds are rarely dangerous, and knowing what to do (and what not to do) makes all the difference when you or your child has blood running down their face. Knowing nosebleed first aid skills gives you the ability to act when someone needs help. Book your first aid course today and learn the skills that matter when every second counts.

FAQs

Can Medication Cause Nosebleeds?

Aspirin and other blood-thinning medications do not directly cause blood vessels in the nose to break, but it prevents platelets from clumping together to form clots. If a nosebleed starts for any reason, these medicines make the bleeding harder to stop.

Why Do Children Get More Nosebleeds Than Adults?

Children between ages 3 and 10 have nosebleeds more often because the blood vessels in the front of their nose sit closer to the surface and are more easily irritated. Nose picking, frequent colds, and dry indoor air during school months all contribute as well.

Why Do High Altitudes Cause Nosebleeds?

At higher altitudes, the air is thinner and drier, which draws moisture out of the nasal lining. The lower air pressure also means blood vessels in the nose expand. Combined, these factors make nosebleeds common when flying, hiking at elevation, or travelling to mountainous areas.

Table of Contents

Sharon McCulloch
CEO, Founder and First Aid Trainer at FirstAidPro

Sharon McCulloch is the CEO and Founder of FirstAidPro, Australia’s leading Registered Training Organisation (31124), delivering First Aid Courses nationwide.

Sharon Mcculloch FirstaidPro

Sharon has 21+ years of experience as a qualified Emergency Care Nurse registered with the Australian Health Practitioner Regulation Agency (APHRA) and 12+ years as a First Aid Trainer.

She takes pride in FirstAidPro making first aid training available, comprehensive and affordable to everybody.

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