Lean forward, not back. Tilting the head back sends blood down the throat, where it gets swallowed, causes nausea and hides how much is actually being lost.
The method
- Sit up and lean the upper body forward.
- Pinch the soft part of the nose — both nostrils, firmly, below the bony bridge. Not the hard part at the top.
- Hold for a full 10 minutes without letting go. This is where most people fail. Releasing at four minutes to check breaks the clot that was forming and starts the clock again.
- Breathe through the mouth and spit out any blood that runs back, rather than swallowing it.
- A cold compress on the nose or the front of the face can help. So can sipping a cold drink or sucking ice while you hold.
After 10 minutes, release gently and check. If it starts again, pinch for another 10. If it is still bleeding after 20 minutes of pressure, go to your nearest emergency department.
What not to do
- Do not tilt the head back.
- Do not pack the nostrils with tissues or cotton wool.
- Do not keep releasing to check. Ten minutes means ten minutes.
- Do not pinch the bony bridge — there is nothing to compress there.
For the next 24 hours
The clot is fragile and easy to dislodge, which is why so many nosebleeds restart the same evening.
- Do not pick or blow the nose, however uncomfortable it feels
- Avoid strenuous activity and sport
- Avoid hot food, hot drinks, and hot showers or baths
When to get it looked at
See a doctor as soon as you can if:
- It follows an injury, especially a head injury
- The bleeding is very heavy
- There is trouble breathing or chest pain
- The person feels dizzy or lightheaded
- It lasts longer than 20 minutes
- The person is a child under 2
- They are vomiting blood
Seek urgent medical attention if the person takes blood-thinning medication. For anything urgent, call 000.
For non-urgent advice you can call healthdirect on 1800 022 222 and speak to a nurse at any hour.
A nosebleed after a head knock is a different problem
Blood from the nose or ears after a head injury can indicate something more serious than a burst vessel. Do not try to stop it with packing, and get the person assessed.
This is a summary of what is taught in class, not a substitute for training. Skills like this are assessed practically for a reason — reading about them is not the same as having done them. In a real emergency, call 000.
Learn it properly
Bleeding control, including nosebleeds, is taught in HLTAID011 first aid including CPR and HLTAID012 childcare first aid. See also severe bleeding first aid.
Sources: Healthdirect Australia, Nosebleed treatments; Australian and New Zealand Committee on Resuscitation, ANZCOR Guideline 9.1.1 — First Aid for Bleeding.
