Gushing nosebleed: what to do

Nosebleeds begin when small blood vessels inside the nose break. Dry air, rubbing, nose picking, forceful blowing, allergies, a cold, or local irritation can make this more likely. Sinusitis may inflame nearby tissue. Some people also have high blood pressure or take medicines that affect clotting, which can make bleeding harder to control; a nosebleed does not by itself diagnose hypertension.

Blood can look especially plentiful when it mixes with saliva or runs toward the throat. Nosebleed is the symptom, while the cause may be local or related to a medicine or health condition. Tell a clinician about repeated episodes, easy bruising, or bleeding from other sites.

Sit upright and lean slightly forward so blood does not collect in the throat. Breathe through your mouth. Pinch the soft, fleshy part of the nose firmly, not the bony bridge, and keep steady pressure without checking repeatedly. Spit out blood rather than swallowing it. Do not lie flat, tilt the head back, blow the nose, or pack it with tissue. Once it stops, avoid strenuous activity and nose blowing for a while.

Call emergency services or attend an emergency department if bleeding is pouring out, does not settle with firm pressure, causes faintness or breathing difficulty, follows a significant head or facial injury, or occurs with blood-thinning medicine and ongoing flow. Seek prompt medical review for repeated gushing episodes, unusual bruising, or bleeding from the gums or elsewhere.

Ask whether a medicine, nasal treatment, allergy, or blood-pressure issue could be contributing; whether the inside of the nose needs examination; and how to prevent another episode safely.