Some Basics...

• Nosebleeds are common.
• Most nosebleeds (90%) come from the front part of the nose. These are easily treated.
• Most nosebleeds will stop when pressure is put on the bleeding area. The best method is to squeeze both nostrils using the thumb and index finger. Keep squeezing for 10-15 minutes. This puts pressure on the inside of the nose to stop bleeding.

Causes

• Colds
• Dry air
• Nose-picking

Risk Factors

• Age: It is harder to stop nosebleeds in elderly people.
• Environmental: These factors include temperature and dryness of the air.
• Local: These factors include colds, nasal drug inhalation, nose tumors, and septal deviation. Nose blowing and picking can also be factors.
• Medications: Certain drugs can increase bleeding. These include aspirin, ibuprofen, naproxen, heparin, warfarin (Coumadin), and Plavix (clopidogrel). It is harder to stop nosebleeds in people who take blood thinners.
• Systemic: These factors include hypertension, arteriosclerosis, and coagulopathies.

1. What You Should Know:
   • Nosebleeds are common.
   • You can treat mild nosebleeds at home.
   • Here is some care advice that should help.
2. Treating a Nosebleed - Pinch the Nostrils:
   • First blow your nose to clear out any large clots.
   • Lean slightly forward. This keeps the blood from trickling down the back of your throat.
   • Gently squeeze the soft parts of the lower nostrils together. Use your thumb and your index finger to pinch them together. Do this for 10-15 minutes. Use a clock or watch to measure the time. Your goal is to put constant pressure on the bleeding point.
3. Treating a Nosebleed - Inserting a Gauze with Decongestant Nose Drops:
   • If putting on pressure fails, wet a piece of gauze with decongestant nose drops. Put this in your nose. You can also use petroleum jelly. The gauze will put pressure on the nose. The nose drops will help shrink the blood vessels.
   • Then repeat the steps of gently squeezing the lower nose for 10 minutes.
   • Afrin (oxymetazoline) nasal spray is a nasal decongestant that is sold over-the-counter (OTC).
4. Caution - Nasal Decongestants:
   • Do not take these drugs if you have high blood pressure, heart disease, an enlarged prostate, or an overactive thyroid.
   • Do not take these drugs if you are pregnant.
   • Do not take these drugs if you have used a MAO inhibitor in the past 2 weeks. MAO inhibitors include isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
   • Do not use these drugs for more than 3 days.
5. Prevention:
   • Dry air can cause nosebleeds. Use a humidifier to keep the nose from drying out. You can also put petroleum jelly on the center wall inside your nose. Do this 2 times a day. This will help the nose to heal.
   • Bleeding can start again if you rub your nose or blow too hard. Avoid touching your nose and nose-picking. Avoid blowing the nose.
   • Do not take aspirin or other anti-inflammatory medications until told to by your doctor. These include ibuprofen, Advil, Motrin, Aleve.
6. What to Expect:
   • Almost all nosebleeds will stop after 15 minutes of direct pressure.
   • After swallowing blood from a nosebleed, you may feel sick to your stomach. You may later pass a dark stool with blood in it.
7. Call Your Doctor If:
   • Nosebleed lasts more than 30 minutes after using direct pressure
   • Feel lightheaded or weak
   • Nosebleeds get worse or happen often
   • You get worse