What should you know about acute epistaxis?

Epistaxis is the medical term for bleeding from inside the nose. Delicate vessels near the front of the nasal septum are a frequent source, although bleeding can arise farther back and be harder to control. Dry air, nose picking, forceful blowing, an injury, inflammation, and medicines that reduce blood clotting can contribute.

Allergic rhinitis, a common cold, or sinusitis may inflame the lining and make bleeding easier to trigger. These conditions can present with nasal irritation or congestion alongside a nosebleed, but the bleeding itself does not establish the cause. High blood pressure may make an episode more difficult to manage, so clinicians may check it during assessment.

Sit down and lean slightly forward so blood does not run into your throat. Spit out blood that reaches the mouth. Pinch the soft, fleshy part of both nostrils firmly and continuously for ten to fifteen minutes without releasing to check. Breathe through your mouth and place a cool pack over the nose if comfortable.

Once bleeding stops, avoid picking or blowing the nose, hot showers, strenuous activity, and bending low for the rest of the day because these can disturb the clot. Do not pack the nostril with tissue or tilt your head back. If you use a blood-thinning medicine, do not skip or change it without specific clinical advice.

Seek urgent medical help if firm pressure does not stop the bleeding, blood loss is heavy, blood is pouring into the throat, or you feel faint, weak, breathless, or confused. Emergency assessment is also appropriate after a significant injury to the face or head, or when breathing is obstructed.

Contact a clinician soon if nosebleeds keep returning, you bruise unusually, bleeding occurs elsewhere, or you take medicine that affects clotting. Recurrent episodes may need examination of the nasal lining, a medicine review, and treatment such as sealing a visible bleeding vessel or nasal packing.

Ask where the bleeding appears to start, whether nasal dryness or inflammation is contributing, and how to use any prescribed nasal treatment. Bring a current medicine list and ask whether any product affects clotting. If episodes recur, clarify which warning signs require emergency care and whether specialist assessment is appropriate.