Acute anterior epistaxis: what to know

The usual first-aid approach is to sit upright, lean forward and pinch the soft part of the nose continuously. Breathing through the mouth prevents repeated checking, which can disturb the forming clot.

Anterior means that the bleeding begins near the nostrils, where delicate surface vessels can dry, crack or become irritated. Blood may come from one nostril or run into the mouth when the head is tilted back.

Dry air, forceful nose blowing, nose picking, a minor knock and nasal inflammation can trigger an episode. Medicines that reduce clotting can make bleeding harder to stop. High blood pressure may complicate assessment, but a nosebleed alone does not establish that diagnosis.

Sit upright and lean slightly forward. Spit out blood that reaches the mouth rather than swallowing it. Using a thumb and finger, firmly compress both soft sides of the nose just below the bony bridge and hold without releasing for ten to fifteen minutes. A cool pack over the cheeks may feel soothing, but pressure is the key action.

Do not lie flat, tip the head backward or pack the nostril with loose tissue. After bleeding stops, avoid picking, forceful blowing, strenuous exertion and very hot showers for the rest of the day. Do not stop prescribed blood-thinning medicine on your own; a clinician can advise whether any change is appropriate.

Seek urgent help if bleeding is heavy, affects breathing, causes faintness or weakness, follows a significant face or head injury, or continues despite two uninterrupted rounds of correct pressure. Emergency assessment is also appropriate when blood is pouring into the throat or the person is pale, confused or difficult to wake.

Arrange a clinical review for repeated episodes, easy bruising, bleeding elsewhere, or a nosebleed while taking medicine that affects clotting. A clinician can inspect the nose, check relevant medicines and decide whether cautery or nasal packing is needed.

Ask which part of the nose appears to be bleeding, whether dryness or inflammation needs treatment, and how to use moisturising nasal care safely. Bring a complete medicine list and mention any recent injury, frequent episodes, bruising or family history of bleeding problems.