Nose & Sinus
Nosebleeds (Epistaxis)
Nosebleeds are common and most can be managed at home. The steps below are the practice's general instructions for treating a nosebleed. Heavy or persistent bleeding needs emergency care.
When to Seek Emergency Care
If bleeding is heavy or does not stop after the measures below, go to the emergency department or call 911. This page is general information and does not replace instructions given to you directly by ENTCare SWFL.
Step by Step
How to Treat a Nosebleed
- 01
Pinch and Hold
Pinch or clamp the lower part of your nose so the nostrils are held shut. Hold for 15–30 minutes, and repeat as necessary. Sit upright with your chin tucked to keep blood from running down the back of your throat.
- 02
Use Afrin® During Active Bleeding
Apply over-the-counter Afrin® (generic: oxymetazoline) nasal spray into the nose as needed during active bleeding. It is a decongestant that causes vasoconstriction — a clamping down of small blood vessels. Do not use it preventatively, as this can lead to rebound congestion.
- 03
Packing for Severe Bleeding
Severe bleeding may require nasal packing. A cotton ball soaked in Afrin®, a tissue or a small tampon may be used to pack the nose. Keep the packing moist and remove it after several hours to check whether bleeding has stopped.
- 04
Stay Calm
Try to remain calm. An elevated heart rate and blood pressure will worsen bleeding. Check your blood pressure and treat it as indicated to help prevent future nosebleeds.
- 05
Know When to Get Emergency Help
If bleeding persists beyond all of these measures, go to the emergency department or call 911. Some severe nosebleeds require a blood transfusion, though this is very rare.
- 06
Prevent Recurrent Bleeding
If bleeding becomes recurrent, we recommend applying Ayr® saline gel or Vaseline® to keep the nasal lining moist. You may also be prescribed an antibiotic ointment or need to have nasal cauterization performed in the office.
In the Office
Evaluation of Recurrent Nosebleeds
When nosebleeds keep returning, an ENT evaluation can help identify the source and reduce how often they happen.
Finding the Source
Examination and, when appropriate, nasal endoscopy may be used to locate the bleeding site inside the nose.
Nasal Cauterization
A prominent or fragile blood vessel may be cauterized in the office when this is appropriate for you.
Moisture & Ointments
Saline gel, Vaseline® or a prescribed antibiotic ointment may be recommended to keep the nasal lining moist.
Contributing Factors
Blood pressure, dry air and blood-thinning medications can contribute. Never stop a prescribed medication without guidance from your prescribing physician.
Related Information
Recurrent Nosebleeds?
Repeated nosebleeds can often be evaluated and treated in the office. Request an appointment with Dr. Price Sonkarley.