Posterior Nose Bleed: Causes and Cures

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When Your Nose Won’t Stop Bleeding: Causes and Cures

When Your Nose Won’t Stop Bleeding: Causes and Cures | The Survival Doctorby James Hubbard, MD, MPH

In my last post I wrote how to treat the vast majority of nose bleeds. But what do you do when these methods don’t work and you can’t get to a doctor?

If your nose continues to bleed, despite pinching or packing it, the bleeding may be coming from an injured blood vessel too far back in the nose to get to. These posterior nose bleeds account for about 5 percent of total bleeds. For these, you’re going to need something skinny enough to go through the nose that can also expand beyond the nostril into the back of the throat.

If getting to a doctor is possible you should go and not waste valuable time trying a difficult procedure. Since posterior nose bleeds tend to involve an artery, you can loose a lot of blood fast.

If getting to a doctor is impossible, commercial devices for posterior nose bleeds are available. They’re called double balloon catheters. But you’re more likely to be able to get your hands on a Foley catheter—the kind you insert into the bladder for urination. So that’s what I’ll use to describe the procedure. I’ll also describe a makeshift version for when you have no Foley.

I’d never try this unless the bleeding is bad and there’s no way you can get to a doctor within a few hours. The procedure is difficult and uncomfortable and can even be dangerous.

>> Page 2: Foley catheter procedure.

>> Skip to: Alternate procedure (if you have no Foley catheter).


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Photo: Flickr/Laurent Diebold.

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  • Visforvanessa

    I just suffered from posterior nose bleed last week, the first itme my nose has ever bled. I was admitted into the hospital for 5 days as they waited for the bleeding to stop and weigh the need for surgery. I now went from living a life of activity to feeling like I’m made of glass. Will this happen again? I was told this is something that is common in elderly patients. I now spend every 2 hours spraying my nose with saline and living with tissues.

    • James Hubbard, MD, MPH

      Are you taking blood thinners including aspirin?
      When everything heals up well enough for an ENT to run a tube in there and look around you’ll have a better idea of the liklihood it will happen again.

  • Jon

    Thanks for the article. I have not been thoroughly diagnosed yet, but have a family history of HHT. Though rare, I do get nosebleeds bad enough where the blood is flowing out both nostrils and down my throat. It’s very scary. I wish someone would invent a biodegradable expanding foam that could be shot up the nose and left to expand for a while, and when it naturally disintegrates the wound could have healed.

    Anyways, I don’t let fear stop me from going on adventures but I dread the day that something like that happens and I’m not near medical service.

    • James Hubbard, MD, MPH

      Thanks for sharing, Jon.

  • Hilary RN On Call

    Using a tampon works well and is very simple. Just insert into the bleeding nare as far as the applicator will go, push the plunger in a tiny bit more, and then remove the applicator. Tip the head forward, apply ice to the back of the neck, and breathe through the mouth. If this doesn’t work, be sure to see a Dr.
    Regular size works best because supers are usually too big for the nostril. Oh ya, unscented is preferred ;)
    Hilary RN Homecare Nurse

    • James Hubbard, MD, MPH

      Hilary, tampons work great for anterior nosebleeds. But they can’t get to the posterior ones.

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