Ask Dr. Louise

How can I stop a bad nosebleed on my own?

 

Inside your nose are two sets of blood vessels, one in front of the bone that your nose is attached to, called anterior, and one behind that bone, called posterior. Posterior nosebleeds are harder to stop because it’s difficult to apply direct pressure to blood vessels that far inside your nose. Luckily, 90% of nosebleeds are anterior and most can be stopped easily by applying direct pressure by pinching your nose shut. Using oxygen dries out the tissues surrounding the blood vessels that line your nose, increasing your chances for a nosebleed. Nosebleeds are also more common in dry climates like Eastern Washington, and during the winter months as the air inside your home loses moisture from daily use of a furnace or wood stove.

To prevent nosebleeds, keep the tissues inside of your nose moist by applying an ointment like petroleum jelly (Vaseline®) or protective gel to your nostril with a Q-tip. If you wear oxygen tubing with prongs that extend into your nostrils, always use a saline nasal gel instead of a petroleum jelly based ointment because petroleum jelly can dissolve the prongs of the plastic tubing. You are more likely to experience a nosebleed if you take a blood thinner like aspirin, warfarin (Coumadin®), clopidogrel (Plavix®), or newer one like Pradaxa®, Xarelto® or Eliquis®. Using nose sprays like Flonase® or Nasacort® also increases your risk of having a nosebleed. Contact with concentrated nasal spray irritates the delicate tissue that separates your nostrils, called the septum. Avoid nosebleeds by pointing the nozzle away from your septum as you spray.  

To stop a nosebleed, apply direct pressure to the blood vessels by pinching your nose closed. Leaning forward and pinching your nose shut puts even more direct pressure on the blood vessels inside your nose. Leaning forward instead of backward increases the amount of pressure and decreases the chance of swallowing blood, which irritates the stomach and can cause nausea and vomiting. You can increase the direct pressure even more with a wad of cotton or gauze. Any flat cotton or gauze can be rolled up tight to form a nice plug to push into your nostril.

For best results, keep your nose pinched shut for 10-15 minutes without letting up on the pressure. Doctors use Afrin® nose spray to control bleeding because it acts quickly to shrink blood vessels. Afrin® nasal spray and its generic, oxymetazoline, are inexpensive and sold without a prescription.

You can also try a non-prescription blood clotting dressing like calcium alginate or oxidized cellulose, sold in most drug stores in the first aid section. Calcium alginate, available as Nasal Cease® or Bleed Cease® is a dressing made from brown algae. It’s very absorbent and works by releasing calcium on contact with blood, turning it into a gel and jump starting the clotting process. Oxidized cellulose is derived from plants and has been used to stop bleeding in surgery since the 1960s. It is available over-the-counter in several forms, including bandages and gauze dressings. Quick Seal® for nosebleeds contains several gauze plugs impregnated with oxidized cellulose. 

 

5 Tips for Stopping 

a Nosebleed:

 

1. Always lean FORWARD. Pinch your nostrils shut and keep holding them closed for 10 to15 minutes. If that doesn’t work, try spraying two sprays of Afrin® (oxymetazoline) nasal spray into each nostril or onto a tight plug of gauze or cotton before inserting it and then pinching your nose shut for 10-15 minutes. 

 

2. If you get nosebleeds frequently, put together an inexpensive nosebleed “kit”, with a bottle of Afrin® nasal spray and several gauze pads to make into plugs.  

 

3. Use a blood-clotting product like calcium alginate (NasalCease®) or oxidized cellulose (Quick Seal®), which come in gauze pads or pre-formed plugs.

 

4. If blood runs down your throat even when leaning forward or you’re still bleeding despite using either Afrin® nasal spray or a blood clotting product, you probably have a posterior nosebleed, which is very hard to stop. Seek medical attention.

 

5. If you don’t normally have nosebleeds and are on a blood thinner like aspirin, clopidogrel (Plavix®), warfarin (Coumadin®), Pradaxa®, Xarelto® or Eliquis®, please DO NOT IGNORE your nosebleed. Inform your doctor immediately of any serious nosebleed because it may be the only warning sign of a life-threatening stomach bleed or devastating brain bleed.

 

Dr. Louise Achey, Doctor of Pharmacy is a 39-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Your questions and comments are always welcome at www.AskDrLouise.com   

© 2018 Louise Achey

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