Emergency Department and Minor Injury Unit
You have been given this information because you have been diagnosed with epistaxis, this is more commonly known as a nose bleed. Epistaxis usually occurs when a small blood vessel at the front of the nose ruptures. Most bleeding from the nose comes from an area known as Little’s area. This is just inside the entrance of the nostril.
Minor spontaneous nose bleeds are very common.
Most nose bleeds occur due to the rupture of fragile blood vessels with no apparent reason. This may be exacerbated by having a common cold, picking the nose or nose blowing. Rarely nose bleeds occur due to blood clotting disorders or blood thinning medication.
You should always let the doctor know if you have a blood clotting disorder, or are on blood thinning medication (for example; warfarin or rivaroxaban).
The main treatment for a nose bleed is pressure to the bleeding area.
- Pinch the lower end of the nose with the index finger and thumb
- This should block both nostrils
- Do not lean your head back, this will cause blood to go down your throat or airway
- A cold flannel or ice pack applied to the forehead can slow bleeding
- Continue this for 10 minutes
- If bleeding has stopped after this do not pick or blow your nose
- If bleeding continues repeat pressure for a further 10 minutes
Treatment at hospital
Some patients with persistent epistaxis will have cautery applied (a small burn) to the offending blood vessel, or referral to an Ear Nose and Throat (ENT) clinic.
Most patients only need repeated pressure or the application of a cream such as Naseptin. The cream provides a barrier to allow a scab to form in your nose, this can be as effective as cautery. Some patients may need blood tests while at hospital. Most minor epistaxis do not need any investigation.
If needed, pain medication options include the following:
Paracetamol is usually recommended for painful sprains or strains.
Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and may also limit inflammation and swelling. You can buy some types (for example, ibuprofen) at pharmacies, without a prescription either topically as a cream, or as tablets. You should check the medication advice leaflet to ensure you are safe to take these as some patients with asthma or stomach ulcers may not be able to.
For further advice and information about your condition, please choose from the following:
- ‘NHS Patient Choices’ website: www.nhs.uk
- ‘Making Lives Better’ patient website: www.patient.info
- Telephone NHS 111
- Contact your General Practitioner
- The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW
Telephone: 01642 850850
- The Friarage, Northallerton, North Yorkshire, DL6 1JG
Telephone: 01609 779911
- Redcar Primary Care Hospital, West Dyke Road, Redcar, TS10 4NW
Telephone: 01642 511000
If you have any medical concerns or need advice please contact 111, for further information regarding this leaflet please contact [email protected]
This email will be monitored 9am-4pm Monday to Friday.
Email: s[email protected]
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.