How to Stop a Nosebleed: Step-by-Step First Aid

01Steps

First aid: what to do

• 1. Sit up and lean forward slightly; keep the head above the level of the heart. Do not lie down or tilt back.
• 2. Pinch the soft, fleshy part of the nose (below the hard bone) closed using thumb and forefinger.
• 3. Breathe through your mouth and keep pinching continuously for 10–15 minutes by the clock.
• 4. Spit out blood that collects in your mouth rather than swallowing, which can cause nausea.
• 5. Apply cold: a cold pack or ice wrapped in cloth on the bridge of the nose and cheeks, or suck on an ice cube.
• 6. Check: after 10–15 minutes release slowly; if it is still bleeding, pinch for another 10–15 minutes.
• 7. If it persists after two attempts (about 30 minutes), seek medical care.

02Dont

What not to do

• Do not tilt your head back; blood runs down the throat and may cause vomiting or aspiration.
• Do not lie flat.
• Do not stuff tissues or cotton deep into the nose; they can restart bleeding when removed (a small piece placed gently at the front is acceptable).
• Do not release the pinch every minute to check.
• Do not blow your nose, pick it or sniff hard afterwards.
• Do not use aspirin or ibuprofen unless needed and advised.
• Do not apply pressure to the hard bony bridge; it does not stop bleeding.

03Aftercare

After the bleeding stops

• Avoid blowing your nose, picking, heavy lifting, bending over and strenuous exercise for 24 hours.
• Avoid hot drinks, hot baths and alcohol for the first day.
• Apply a thin film of petroleum jelly or a saline gel inside the nostril to keep it moist and protect the area.
• Keep the head elevated when sleeping.
• Sneeze with your mouth open.
• Use a saline spray to keep the nose moist.
• Rinse the nose gently only after a day.

04Why

Why nosebleeds happen

The front of the nose has a rich network of fragile blood vessels (Kiesselbach’s plexus) that bleed easily, which is where about 90% of nosebleeds come from. Common causes are dry air, nose picking, colds and allergies, nasal sprays and blowing hard, minor injury, and a deviated septum. Posterior nosebleeds, from deeper in the nose, are less common, heavier and more likely in older adults and people with high blood pressure or on blood thinners. See nosebleed causes.

05Wont

If the nosebleed won’t stop

If bleeding continues after 20 minutes of proper continuous pressure, recheck your technique: pinch the soft part, not the bony bridge, and keep pressure without releasing. A decongestant spray containing oxymetazoline can be used in some people (one or two sprays in the bleeding nostril before pinching) if you do not have high blood pressure or heart disease and it is not contraindicated; check with a pharmacist. If bleeding persists after about 30 minutes, go to urgent care: a doctor may cauterise the vessel, pack the nose, give tranexamic acid or arrange a specialist referral.

06Kids

Nosebleeds in children

• Common, usually from picking, dry air or colds.
• Use the same first aid; reassure the child and keep them calm and upright.
• Keep fingernails short and use saline gel to keep the nostrils moist.
• Nosebleeds in children under 2, with bruising, with other bleeding, or very frequent, need medical review.
• See a doctor for bleeding after a head injury.
• See blood when blowing your nose.

07Meds

Blood thinners and other risk factors

People on warfarin, DOACs (apixaban, rivaroxaban), aspirin, clopidogrel or on non-steroidal anti-inflammatory drugs may bleed more heavily and for longer. Do not stop these medicines without medical advice, but contact your doctor for nosebleeds that are heavy or frequent. High blood pressure, liver disease, bleeding disorders, nasal tumours and a condition called hereditary haemorrhagic telangiectasia (HHT) can also cause recurrent nosebleeds.

08Prevent

Preventing nosebleeds

• Humidify the bedroom, especially in winter or with heating.
• Apply petroleum jelly or saline gel inside the nostrils twice a day.
• Use saline spray to keep the nose moist.
• Do not pick, rub or blow the nose forcefully.
• Use nasal steroid sprays as directed, aiming away from the septum.
• Treat allergies and colds.
• Keep fingernails short, particularly for children.
• Control high blood pressure.

10Cases

Three common situations

A dry-winter nosebleed in a healthy adult: lean forward, pinch for 10–15 minutes; use saline gel afterwards.

An older adult on warfarin with bleeding for 30 minutes: go to the emergency department.

A child with a nosebleed after picking: pinch the soft part, keep them upright and calm; trim nails.

11Summary

Key points to remember

Sit up, lean forward and pinch the soft part of your nose for 10–15 minutes. Do not tilt your head back. Protect the nose afterwards and seek urgent help if bleeding persists or you take blood thinners. Our ENT team can treat recurrent nosebleeds.

This guide is for general information and does not replace an examination by your own doctor or ENT specialist.