Nosebleeds can be caused by high blood pressure, heat, after a blow to the nose, or as a result of violent sneezing, picking or blowing the nose. Any of these triggers can cause the tiny blood vessels inside the nose to break, causing a bleed which can be very dangerous if not stopped.
If the bleed follows a head injury it could also appear thin and watery, which is a serious sign. The clear fluid could be cerebral spinal fluid, which surrounds the brain. It is normally contained within the skull, so if it is leaking out of the nose it indicates that the skull is fractured.
However, regardless of the cause, the basic treatment remains the same.
Treatment For Nosebleeds
As with any type of bleeding, the first course of action is to reassure the casualty and ask him to sit down.
Ask him to tilt his head forwards to allow the blood to drain out of the nostrils. Do not allow him to tilt his head back, as this causes the blood to run down the throat and cause vomiting and/or choking.
Get the casualty to pinch the soft part of the nose while leaning forward and to breathe through the mouth. If the bleed was caused by a blow to the nose be aware that the nose may be bruised or broken, and could be painful for the casualty to touch, but try to persuade him to pinch it anyway.
You can also give him something to catch the blood (a cloth or a bowl) - this is not essential, but may reassure the casualty as he will not see the blood dripping onto the floor, and it will give him more of a sense of control.
After 10 Minutes
After 10 minutes ask him to release the pressure on the nose to see if the bleeding has stopped. If it hasn't, ask him to hold the nose again for up to two further periods of 10 minutes.
If the bleeding stops and then restarts ask the casualty to reapply the pressure.
If the nosebleed is severe, or if it lasts longer than 30 minutes, continue the pressure on the nose and get the casualty to hospital as he may start to suffer the effects of blood loss. If it is very severe be prepared to treat for shock, by keeping the casualty warm and closely monitoring him in case he goes unconscious.
Once the bleeding has stopped, keep the casualty leaning forward and clean around the nose with lukewarm water. Do not use hot water as this can cause the bleeding to restart.
Advice To Give
During and after treatment you can give the casualty the following advice:
- Try not to cough or sniff as this can loosen any blood clots which have formed.
- Rest quietly for a few hours after the nosebleed. Try to avoid any exercise. If the casualty is a child it may mean not allowing him out into the playground at school, or keeping him occupied in the house for a while.
- Don't blow the nose because this could disturb blood clots and the bleeding could restart. If the casualty is a small child you may also have to tell him not to pick his nose.
* The advice given here follows guidelines by St John Ambulance in the UK. First aid procedures in other countries may be different.
* This article is intended as advice only and should not be treated as a substitute for attending a first aid course.
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