Emergency Physician Questions Nosebleed

What should be the first aid for nose bleeding?

My grandfather has suddenly started to get nosebleeds, and he has never gotten them before. What should I do every time he gets a nosebleed? What is the first aid for it usually?

4 Answers

Pinch both nostrils shut, tilt his head back for about 10". IF he is still bleeding at that time, he should be seen by a doctor. If he is on aspirin or "blood thinners," then he may be more prone to nosebleeds. Also, an elevated blood pressure can also cause someone to have a nose bleed. Humidifying the air in his room, especially at night if the heat is on, can also help prevent the nose bleeds.
Onset of nosebleeds can be a sign of abnormal blood clotting or uncontrolled high blood pressure. This is especially true in patients on blood thinners. If the problem persists, it would be important to see your primary care doctor to have some blood work checked. Simple first aid steps to help control nosebleeds include the following:

1. Be sure the patient is seated upright with the head above the level of the heart and shoulders.

2. Gently blow each nostril to be sure there are no large blood clots inhibiting the nosebleed from clotting.

3. With the thumb and first finger, firmly pinch the nose just before the bone, that is, the bridge of the nose, fully occluding both nostrils. Hold firmly for 3 to 5 minutes to encourage the bleeding spot to clot.

4. Release and repeat steps two and three if there is still ongoing bleeding.

5. If bleeding continues, try applying a nasal decongestant like Neo-Synephrine or Afrin to the side that appears to be bleeding, then reapply pressure.

6. Sometimes, by holding an ice cube directly underneath the upper lip, you can shrink the blood vessels that might be involved in the bleeding and help control the bleeding.

If none of these steps help stop the bleeding, consult your primary care doctor or seek medical assistance at an urgent care or emergency department.
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My strongest recommendation is to get help at an ER, by professionals. I assume your grandfather is older and may have other health issues like heart problem, high BP, and he may be on aspirin and blood thinners. All these must be considered.

Having said that, you can offer “First Aid” for nose bleeds:

1. Calm him, reassure him
2. Make him sit up
3. Pinch the soft part of his nose with thumb and index fingers
4. Ask him to breathe through the mouth
5. Keep the nose pinched for a full ten minutes, without letting go to check if the bleeding has stopped.
6. Give him something to spit into.
7. Please get him to see a doctor. Some people have self-limiting “minor” nose bleeds. But for older patients, this can be more serious.
8. Blood pressure needs to be monitored and managed.

Good luck,

Dr. Kini (emergency physician)
You should pinch the nose and breathe through the mouth. This should be done until the bleeding stops. It may take several minutes. If the bleeding does not stop, you should go to see a physician or health care provider