Epistaxis (Nosebleed)

Epistaxis, or nosebleed, is bleeding from the blood vessels lining the nose. Most nosebleeds are minor and stop with simple first aid, though recurrent or severe nosebleeds may need further evaluation.

• Bleeding from one or both nostrils, ranging from light to heavy
• Blood may also drain down the back of the throat, particularly if the bleeding source is further back in the nose
• Most nosebleeds are brief and stop within about 10–20 minutes with simple pressure
• Recurrent nosebleeds, or a single episode of very heavy or prolonged bleeding, warrant further assessment

• Most commonly results from minor trauma to the delicate blood vessels at the front of the nasal septum, such as from nose picking, blowing the nose forcefully, or dry air irritating the nasal lining.
• Can also result from an upper respiratory infection, allergies causing frequent nose rubbing, or, less commonly, an underlying bleeding disorder or use of blood-thinning medicine.
• Recurrent or severe nosebleeds occasionally indicate an underlying structural or blood-related condition requiring further investigation.

• Usually diagnosed based on the history and appearance alone, without needing further testing for a typical, minor nosebleed.
• Examination of the nose, where available, can sometimes identify a visible bleeding point at the front of the septum, the most common source.
• Further investigation, such as blood tests, is considered for recurrent, severe, or unexplained nosebleeds, or if an underlying bleeding tendency is suspected.

First aid for an active nosebleed involves sitting upright, leaning slightly forward (not tilting the head back, which can cause blood to be swallowed), and firmly pinching the soft part of the nose for a full 10–15 minutes without releasing to check.

Applying a cold compress to the bridge of the nose can help constrict blood vessels and support bleeding control.

If bleeding does not stop after 15–20 minutes of continuous firm pressure, or if bleeding is heavy, medical assessment is needed, which may include nasal packing or cauterisation of the bleeding vessel.

Recurrent nosebleeds are assessed for an underlying cause, such as dry air, chronic nose picking, or, less commonly, a bleeding disorder or blood-thinning medicine, and managed accordingly.

• Avoid picking or forcefully blowing the nose.
• Keep nasal passages moist, particularly in dry climates or seasons, using saline nasal spray or a humidifier if needed.
• Keep fingernails trimmed in young children prone to nose picking.
• Seek medical assessment for nosebleeds that are frequent, heavy, or difficult to stop with simple pressure.