Nosebleeds

Introduction

Bleeding from the nose most commonly occurs when tiny blood vessels inside the nostrils are ruptured, either by a blow to the nose, or as a result of sneezing, picking or blowing the nose. Nosebleeds may also occur as a result of high blood pressure.

A nosebleed can be dangerous if the casualty loses a lot of blood. In addition, if bleeding follows a head injury, the blood may appear thin and watery. The latter is a very serious sign because it indicates that the skull is fractured and fluid is leaking from around the brain.

Your aims

• To control blood loss.
• To maintain an open airway.

Treatment

• Ask the casualty to sit down.
• Advise them to tilt their head forwards to allow the blood to drain from the nostrils.
• Ask the casualty to breath through their mouth (this will also have a calming effect) and to pinch the soft part of the nose.
• Reassure and help if necessary.
• Tell the casualty to keep pinching their nose.
• Advise them not to speak, swallow, cough, spit or sniff because this may disturb blood clots that may have formed in the nose.
• After 10 minutes, tell the casualty to release the pressure. If the bleeding has not stopped, tell her to reapply the pressure for two further periods of 10 minutes.
• Once the bleeding has stopped and with the casualty still leaning forwards, clean around their nose with lukewarm water.
• Advise the casualty to rest quietly for a few hours. Tell them to avoid exertion and in particular, not to blow their nose, because these actions will disturb any clots.

Caution

• Do not let the head tip back; blood may run down the throat inducing vomiting.
• If bleeding stops and then restarts, tell the casualty to reapply pressure.
• If the nosebleed is severe, or if it lasts longer than 30 minutes in total, take or send the casualty to hospital in the treatment position.

Please note:

These first aid tips are no substitute for thorough knowledge of first aid.

Attend a St John Ambulance first aid course.