Coughing up blood after a nosebleed

Blood from the nose can run backwards into the throat, especially when lying down, and later appear in saliva or mucus. A dry or irritated nose, rubbing, forceful blowing, or some medicines can make this more likely. Blood that comes up with a deep cough, is frothy, or continues after the nose has stopped may be from the airways instead. Chest infection, bronchiectasis, pneumonia, pulmonary embolism, tuberculosis, and lung cancer are among the problems a clinician may consider; coughing up blood does not by itself establish any of them.

Sit upright, lean slightly forward, and pinch the soft part of the nose continuously while breathing through your mouth. Spit out blood rather than swallowing it. Once bleeding settles, avoid nose blowing, picking, hot drinks, smoking, and strenuous activity for a while. Arrange medical advice if the source is uncertain, the blood returns, or you use a blood thinner. Keep track of whether blood follows a cough or comes from the nose.

Seek emergency help for bleeding that is heavy or does not settle, trouble breathing, chest pain, faintness, confusion, or weakness. Same-day assessment is appropriate for repeated blood-stained mucus, fever, worsening cough, or feeling very unwell. Do not lie flat if blood is flowing into your throat or you are short of breath.

Ask whether the blood is most consistent with a nosebleed or haemoptysis, whether your nose needs treatment, and whether medicines or tests could explain recurrent bleeding.