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Nosebleeds may be categorized according to their origin, which is either in the anterior (front) part of the nose or the posterior (back) part of the nose. Bleeding from the lower portion of the nasal septum (the wall between the nostrils) causes anterior nosebleeds.
Posterior nosebleeds originate higher up and further back in the nose where larger artery branches go to the nose, causing serious, heavy bleeding that needs immediate medical attention.
Sit up and lean forward to reduce blood pressure and prevent blood from going to the throat and sinuses.
Continue pressing the nose and sit while leaning forward for 5 to 20 minutes, until the blood begins to clot. For re-bleeding, use a nasal decongestant to spray the nose and constrict the blood vessels. Seek medical attention if you are suffering from frequent nosebleeds, which may be related to an underlying problem, a previous head injury, or use of anticoagulants (blood thinners).
Anterior nosebleed: Most nosebleeds begin in the lower part of the septum, the semi-rigid wall that separates the two nostrils of the nose. Posterior nosebleed: More rarely, a nosebleed can begin high and deep within the nose and flow down the back of the mouth and throat even if the patient is sitting or standing. Vigorous nose blowing that ruptures superficial blood vessels in the elderly and in the young.
Fractures of the nose or of the base of the skull that can cause bleeding and should be regarded seriously when the bleeding follows a head injury. Rarely, tumors (both malignant and nonmalignant) have to be considered, particularly in the older patient or in smokers.
Obviously, when the patient is lying down, even anterior (front of nasal cavity) nosebleeds may seem to flow posteriorly, especially if the patient is coughing or blowing his nose.
It is important to try to make the distinction since posterior (back of nasal cavity) nosebleeds are often more severe and almost always require a physician’s care.
Anterior nosebleeds are common in dry climates or during the winter months when heated, dry indoor air dehydrates the nasal membranes.
Spray nose four times in the bleeding nostril(s) with a decongestant spray such as Afrin or Neo-Synephrine. The majority of nose bleeds occur in the front of the nose called the septum and turbinates. Nose bleeds are more common in extreme weather conditions and during rapid weather changes especially when the air gets both colder and drier quickly. Lean forward, open the mouth to breathe and apply firm pressure to the soft lower third of the nose (essentially squeeze the bottom half of the nose together so you cannot breathe through the nose at all).
By tipping your head forward and down by at least 20 degrees, blood will not run back down to the throat and make you cough and splutter. Hold this for 20 minutes (normal blood will coagulate after 5 minutes and holding longer gives it a margin of security). If you are taking blood-thinning drugs like Warfarin, Aspirin, Plavix, Pradaxa, etc., you will need to continue pressing for longer.
If the bleeding persists, especially down the back of the throat, then the bleeding area is most likely at the back of the nose.
After the bleeding has been arrested, an endoscopic nasal inspection would be advised especially if this has been a recurrent event.
Readers should consult their physician before considering treatment, and should not interpret their condition solely based on the information above.
While most cases are harmless, repeated episodes could point to serious problemslike cancer or high blood pressure.

Dr Chan Kwai Onn, consultant ear, nose and throat surgeon at K O Chan Ear Nose Throat Sinus & Sleep Centre, said that while nose bleeds – or epistaxis – are commonly a result of picking or rubbing your nose, it can sometimes indicate something more serious.
High blood pressure, a blood clotting problem and, in more severe cases, cancer, can cause nose bleeds. Persistent nose bleeds should be seen by an ear, nose and throat (ENT) specialist to determine if they are indeed caused by a minor problem like nasal dryness, he said. Most of the bleeding from the nose occurs at the frontal area of the nasal septum where there is a bunching of blood vessels, said Dr Gerard Chee, consultant ENT surgeon at G Chee Ear Nose Throat Sinus and Dizziness Centre.
Frequent blowing and picking of one’s nose can cause the blood vessels in the nasal cavity to break. What to do when you bleedWhen your nose bleeds, your first reaction might be to tilt your head back to staunch the flow of blood.
You should also avoid stuffing tissue paper up your nose to absorb the blood, said Dr Chee.
Instead of fighting the flow of blood, you should sit up and lean forward to prevent it from going down your throat. Then pinch your nose firmly between your thumb and index finger, just below the nasal bones and hold for five to 10 minutes.
Once the bleeding stops, use a saline nasal spray or nasal gel to keep your nose moist and avoid blowing your nose for several hours after the bleeding stops. However, if your nose is still bleeding after 10 minutes in spite of first aid, you may require silver nitrate cautery or electrocautery to stop the bleeding.
If you suffer from nasal dryness, Dr Chan had this advice: keep your air-conditioner’s temperature to no lower than 24 deg C, or sleep in a non-airconditioned room. About 85 per cent of nose bleeds are due to nasal dryness and it is especially common in children, said Dr Chan. Child Safety and Injury PreventionThis is your chance to get answers to your questions on how to better childproof your home! Home > The Doctors > The Doctors AdviceThe Drs: Bleeding From the Mouth Chest Trauma & 911 for Bloody Nose?
Human Verification: In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic. Patients with epistaxis, commonly called nose bleeds, that are persistent enough to categorize themselves as life threatening nose bleeds may also benefit from embolization. First a diagnostic cerebral angiogram is performed to assess the vessels of the face and nose. To connect with a neuroscience specialist, call 800-633-7377 or complete and submit the form below. Using a humidifier in your home helps keep the air moist, especially if the climate is dry.
Examples are blood thinning medications such as Coumadin, aspirin, ibuprofen, and clopidogrel (Plavix). The septum contains blood vessels that can be broken by a blow to the nose or the edge of a sharp fingernail. Posterior nosebleeds are more likely to occur in older people, persons with high blood pressure, and in cases of injury to the nose or face. They can all be purchased without a prescription: Bacitracin, A and D Ointment, Eucerin, Polysporin, and Vaseline. Using an endoscope, a tube with a light for seeing inside the nose, your physician may find a problem within the nose that can be fixed. In this case, an Ear, Nose & Throat Specialist or hospital care should be sought immediately, as the bleeding is less likely to be controlled by your own applied pressure in the front, and may recur later.

STACEY CHIA reportsWhile there is no need to panic when you get an occasional nose bleed, don’t ignore it if it happens frequently. Also, when it is too dry, the nasal lining cracks and exposes these blood vessels, hence causing a nose bleed.
Travis Stork said the first thing you should do is call 911 and make sure help is on the way. Stork said the biggest things you want to look for are the ABC’s: airway, breathing and circulation. I married the love of my life in June 2012 and we are enjoying settling into married life and all that it entails. Sometimes a blood bank sample needs to be sent and the patient needs to be evaluated by CTA to exclude neoplasm or abnormal anatomy. Also called nasal hemorrhage, nosebleeds occur because the nose has many blood vessels that can bleed profusely even with minor injuries.
A slight bump on the nose can cause anterior nosebleeds, which are easily controlled with home treatment. Treatments may include packing the bleeding nostril, sealing off bleeding blood vessels, or inserting a special inflatable balloon to apply pressure to the bleeders. This type of nosebleed comes from the front of the nose and begins with a flow of blood out one nostril when the patient is sitting or standing. This can be prevented if you place a bit of lubricating cream or ointment about the size of a pea on the end of your fingertip and then rub it inside the nose, especially on the middle portion of the nose (the septum).
Up to three applications a day may be needed, but usually every night at bedtime is enough. He or she may recommend cauterization (sealing) of the blood vessel that is causing the trouble.
But that is alright as long as the cause has been sought for, and importantcauses excluded. Bleeding from the back of the nose also tends to be more profuse as the bleeding points are nearer the feeding arteries with a higher pressure. He said if you ask a person if they can hear you and they don’t respond, help needs to be on the way immediately.
If a person has trauma to their chest, they can bleed from the mouth and you will see coughing in this case.
Not all people are candidates or will benefit from treatment; however at times these patients can be treated by surgical intervention from ENT (ear, nose and throat) surgeons. If it is appropriate to treat the patient, he or she is brought to the angiography suite and placed under conscious sedation or general anesthesia. For patients with severe nose bleeds, our Interventional Neuroradiology staff physicians are usually notified by the ENT service. Once the diagnostic angiogram is completed, a microcatheter is passed through a guide catheter in the appropriate artery. Often patients have already received nasal packing, or a balloon which may decrease bleeding. Branches of this vessel supplying the nasal region are embolized with particles (PVA, Gelfoam, Coils) or other material. Afterward, the patient's leg needs to be kept straight for four to six hours depending on the closure of the initial incision site.

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