Nosebleed First Aid and Prevention

Publication Date: 
Fri, 01/01/2016
By: Alere Staff

A nosebleed, or epistaxis, can be a nuisance, but can also be scary. Once a nosebleed starts, for someone who has to take blood thinners, it’s unpredictable when it will stop. A nosebleed doesn’t have to mean an automatic trip to the ER. Following the proper first aid steps can help you control your next minor nosebleed1,2:

  • Step One: Stay calm. If you become too excited, this may cause even more bleeding.
  • Step Two: Sit up straight and lean slightly forward. Put your head down. It is no longer recommended to lean your head back. This causes the blood to run to the back of your throat and may cause vomiting.
  • Step Three: Use your index finger to apply pressure to the affected nostril. If you are bleeding out of both nostrils, use your thumb and index finger and pinch to apply pressure. You will apply pressure between 10-15 minutes, maintaining your sitting position.
  • Step Four: Release the pressure. If your bleeding has not stopped, seek medical attention.

You may also use nasal antihistamines to control the bleeding. Nasal sprays, such as the Neo-Synephrine® nasal spray, have a vasoconstriction effect on the nasal membranes, which means that it can cause blood vessels to “tighten up.” You should avoid irritating your nose for 24 hours after the bleeding subsides.2 This means avoiding nose blowing, picking and trying your best not to sneeze or strain. It is also a good idea to check your INR immediately after the bleeding stops. This will let you know if the nosebleed occurred because your INR was too high or if there was another reason.

Prevention is another good practice to implement. There are multiple reasons one gets a nosebleed: dry weather, vigorous nose blowing, seasonal allergies and nasal or sinus infections.2,3There are also two types of nosebleeds, anterior and posterior nosebleeds. Anterior nosebleeds are the most common and usually occur when small blood vessels rupture in the lower septum.2Posterior nosebleeds, while less common overall are more common in the elderly. These nosebleeds originate from an artery in the back part of the nose and are usually more complicated, sometimes requiring admission to a hospital and proper medical attention.2

Fortunately, there are some things that can be done to help avoid nosebleeds1,2,3:

  1. Use a saline nasal spray or apply Petroleum Jelly to the nasal membrane with a cotton swab. You do not need a lot and it will prevent dryness.
  2. If you live in a dry area, or it is dry in your house, get a humidifier.
  3. Avoid traumatizing the nasal membrane if you need to pick your nose. Scratching the membrane makes you prone to infection.
  4. Alcohol use can also cause nosebleeds. If you get frequent nosebleeds and you drink, you may want to cut down on how much you consume.

Remembering these first aid steps and tips for prevention should help reduce the frequency of nosebleed occurrences and mean fewer trips to the emergency room.


  1. Mayo Clinic Staff. Symptoms: Nosebleeds. Mayo Clinic. July 3, 2015. Retrieved from the website:
  2. Schwartz, M. M.D. Nosebleed Information for Persons on Anticoagulant Medicines (ACM’s).ISMAAP. Sept. 2013. Retrieved from the website:
  3. Suh, J.D., M.D. et al. Epistaxis (Nosebleeds). American Rhinologic Society. February 17, 2015. Retrieved from the website:

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