Cough and nose bleed: what should you know?

Dry air, forceful nose blowing, frequent coughing, allergies, and nasal inflammation can make small blood vessels bleed. Blood from the nose can run into the throat and be coughed out; this differs from blood coming up from the chest. A cold, allergic rhinitis, or bronchitis may cause coughing and nasal irritation together. Medicines that affect clotting and repeated nosebleeds also change the level of concern. Note the amount, source, duration, and whether the blood is mixed with mucus.

Sit upright, lean slightly forward, and pinch the soft part of the nose continuously while breathing through the mouth. Spitting out blood is safer than swallowing it. Avoid lying flat, picking the nose, forceful blowing, heavy exertion, and hot drinks immediately afterwards. Do not put tissues deep inside the nostril. A pharmacist or clinician can advise about saline care and review medicines that may contribute.

Seek emergency help if bleeding is heavy, follows a significant injury, causes faintness, or comes with severe breathing difficulty, chest pain, or coughing blood that clearly comes from the chest. Arrange medical review for recurrent episodes, bleeding that does not settle with sustained pressure, unusual bruising, or a cough that is persistent or worsening.

Could the blood be from my nose or lower airways? Could dryness, allergy, infection, or a medicine be contributing? How should I prevent another nosebleed? Do I need an examination of my nose or chest?