How to Stop a Nose Bleed

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The Movie Way to Stop a Nose Bleed (and Die)

The Movie Way to Stop a Nose Bleed (and Die) | The Survival Doctorby James Hubbard, MD, MPH

I hope you never stop a nose bleed like they do in the movies. If you do, you just might bleed to death.

Here’s a typical scene: The hero has been punched in the face and his nose is bleeding pretty badly. He sits down, tilts his head back, and pinches the bridge of his nose or applies an ice pack to that area. Well, at least they get one thing right.

Movie Nose Bleeds: Rights and Wrongs

Step 1: Sit.
Right.

If you don’t feel faint, sitting is preferable to lying. It lowers the blood pressure to the bleeding blood vessel. It’s like a water hose. The higher you lift the nozzle, the less water pressure there is and the easier it is to stop the flow with your thumb.

If you feel dizzy, go ahead and lie down, or put your head between your knees. The bleeding may be a little harder to stop, but at least you’ll remain conscious and not incur an additional injury.


Step 2: Tilt your head back.

Wrong.

The Survival Doctor guide booksThe blood will run down the back of your throat where it can cause choking. Also, swallowing a lot of blood can cause stomach irritation. Tilt your head forward so the blood runs out your nose.


Step 3 (a): Pinch the bridge of your nose.

Wrong.

This does nothing to stop the bleeding. You need to pinch together the fleshy part of your nostrils, below the bony part, for about ten minutes. This applies pressure to all the blood vessels in that part of your nose and stops the bleeding if it’s coming from there. And odds are, it is.


Step 3 (b): Apply ice.

Wrong.

It’s true that ice can constrict blood vessels, decreasing blood flow and pressure to the bleeding area. But direct pinching, at least initially, is much more effective, and it’s hard to do both. Besides, the bleeding is almost certainly coming from a blood vessel in your nasal septum (that thin bone that separates your nostrils). A cold pack may help external bruising and swelling but is not going to make much of a temperature difference at the nasal septum.
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>> Click here for The Survival Doctor’s Guides: Ultimate survival for action heroes—when you’ve just survived a knife fight and run from a burning building but can’t go to the hospital because corrupt cops will find out where you are. (Story of our life!)

How to Keep the Bleeding Stopped

If your nose has stopped bleeding, be sure not to pick at the scab or knock it off by blowing too hard. Consider using antibiotic ointment in your nose or saltwater nose spray to keep the lining moist.

How Far Does the Cotton Go?

As long as you just use your finger for the packing (not a small utensil), you shouldn’t be able to stuff cotton or cloth past the main nostril area—and you don’t want to because that would make it hard to get out. As you know if you’ve ever stuck your finger up your nose, the opening becomes very small toward the top.

Packing Complications

These are some potential complications from packing your nostrils:

  • Trauma to the delicate nasal lining. Be as gentle as you can.
  • Bleeding as a result of trauma.
  • Infections, even abscesses, which may require antibiotics.
  • Sinus infections as a result of stopping up the sinus openings and which may require antibiotics.

If your nose is still bleeding after ten minutes of pressure:

  1. Pinch just one nostril at a time to see if you can figure out what side is bleeding. Sometimes it’s both.
    -
  2. Pack the bleeding side (or both, if both are bleeding) with something small enough to stuff in the nostril but large enough to give adequate pressure to stop the bleeding. Lubricate the packing with petroleum jelly or antibiotic ointment if available.
    -
    Several cotton balls make a good stuffing, but you need to push them in deep enough that it actually feels uncomfortable, and you need to have forceps or tweezers or something to get the cotton balls out later. A tampon works well because you can stuff it in and it will expand with the moisture of the bleeding. Also it has a string attached so you can pull it out later. If nothing else, you can use a piece of cloth. Rip it to size and start stuffing.
    -
    If this packing stops the bleeding it needs to stay in twenty-four hours minimum. Forty-eight hours is better. Keep a piece of tape over that nostril to keep the packing from loosening, or even falling out.
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  3. One other thing you might consider is spraying the packing with some blood vessel constrictor, like Afrin or Neo-Synephrine, before you put it in. Don’t do this if you have high blood pressure though, even if your blood pressure is being treated and under control. These vasoconstrictors have a tendency to raise it too much.

If your nose bleed continues despite packing but stops bleeding when you pinch the nostril shut, your packing is probably not in tight enough. Stuff a little more, or try repacking.

Coming Thursday: Nose Bleeds 2: River of Blood (or what to do if your nose bleed continues despite all this).

What about you? Have you ever had to pack your nose, or have it done? How did it work? How did it feel?

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  • the nose bleed club

    i usually use a square of toilet paper, which i roll up and and bend in half and stuff my nose that way. it works wonders, if it doesn’t fit cut the square in half, and try again.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thanks.

  • Marie

    I have had nosebleeds my whole life. They were a continual flow for about 10 minutes when I was a kid. My parents had me lie back on the couch. Then I would end up with a stomach ache. Today I just pack it and keep pressure as you would any bleed. It’s a pain especially in dry air (summertime and wood heat). Today they only last about a minute but my son has inherited this same problem. Any ideas on this?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Marie, sounds like you have it under control. If you’re worried about your son, just make sure he doesn’t have high blood pressure, anemia, any other blood disorders, and doesn’t pick at his nose. If he has allergies or the air is dry in your area, he might benefit from some saline nasal spray and a humidifier.

  • Pingback: Posterior Nose Bleed: Causes and Cures

  • bob robert

    Who is the girl in the picture? Is she OK? What happened to her?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Bob, that’s a stock photo. I don’t know her.

  • Kate

    I never gave much thought to nosebleeds until my boyfriend starting having them regularly. One incident held him hostage as he stood over the sink for more than an hour.
    His physician has him using Premarin Cream (yes, vaginal cream) to help keep the tissue of the nasal passages healthy and moist. Not a cure, but does help.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Kate.

  • http://www.practical-parsimony@blogspot.com Practical Parsimony

    I ended up in the ER after an hour-long nosebleed that ran like a faucet. The new doctor had me lie down and the more experienced doctor was very upset. She had me sit up.

    Atilla the Hun is said to have died of a nosebleed.

    The whole experience was very frightening since I started bleeding in a university building with only three people left on four floors. The bathroom and halls looked as though a homicide had been committed. I looked like I had been savagely attacked. I had blood all over me. I was choking on blood and would cough and gag trying not to aspirate it. I could not breathe at some points. As the bleeding became worse, I went to the ER.

    They packed my nose at the hospital but made me wait so they could unpack it in case it bled again. I hated the mouth-breathing I had to do!

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Practical, if it happens again, start with the pinching until you can get to a doctor.

  • http://kokoronagomu.deviantart.com gin

    my mum had always folded a dry paper towel (or paper or cloth, anything clean and dry) and tucked it under the top lip… old remedy that seemed to work pretty well. i had used that along with packing the nostril.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Gin.

  • John Gardner

    I learned during those years in prehospital care that people underestimate nose bleeds and don’t seek help soon enough.
    By the time help arrives, vitals signs are a concern.
    Once, in the ER days, I gavaged over a unit of blood from a patient whose treatment only took ten minutes, a sure sign that the patient had bled for awhile. Yes, he had his nose in the air when he arrived.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Gardner.