Emergency Care for Nosebleeds: What to Do When the Bleeding Won’t Stop

Nosebleeds can be alarming, especially when they seem to come out of nowhere or won’t stop quickly. While most are minor and can be managed at home, some cases require emergency care. Understanding when and how to respond can make a big difference in managing the situation safely and effectively.

Why Do Nosebleeds Happen?

Nosebleeds (epistaxis) occur when the tiny blood vessels inside the nose break. Common causes include:

Dry or cold air
Nose picking or blowing too hard
Injury to the nose
Allergies or infections
Blood-thinning medications
Underlying medical conditions like high blood pressure or clotting disorders

First Aid Steps for a Nosebleed

Most nosebleeds can be treated at home with a few simple steps:

Stay Calm: Panic can raise your blood pressure and worsen bleeding.
Sit Upright: Keep your head above your heart to reduce blood pressure in nasal vessels.
Lean Forward: This prevents blood from flowing down your throat, which can cause nausea or vomiting.
Pinch Your Nose: Using your thumb and index finger, pinch the soft part of your nose shut. Hold it for 10–15 minutes without checking to see if it stopped.
Apply a Cold Compress: Place an ice pack on the bridge of your nose to constrict blood vessels.

When to Seek Emergency Care

You should seek medical attention immediately if:

The bleeding lasts longer than 20 minutes despite pressure.
The nosebleed follows a serious injury (e.g., after a fall or blow to the head).
You're experiencing frequent or recurrent nosebleeds.
The bleeding is very heavy or you're coughing up or vomiting blood.
You have a condition or are on medication that affects blood clotting.

What to Expect at the ER

In an emergency setting, healthcare providers may:

Use nasal packing or cauterization (burning the bleeding vessel) to stop the bleed.
Administer medications to constrict blood vessels.
Investigate and treat underlying conditions that may be causing the issue.

Prevention Tips

To reduce your risk of nosebleeds:

Use a humidifier in dry environments.
Keep nasal passages moist with saline sprays or gels.
Avoid picking your nose or blowing it forcefully.
Treat allergies and sinus problems promptly.

You should visit a doctor for a nosebleed if:

Bleeding lasts longer than 20 minutes, even after applying pressure.
Nosebleeds occur frequently (e.g., several times a week or more).
The bleeding is very heavy or you are losing a large amount of blood.
The nosebleed happens after a head injury or trauma to the face.
You are taking blood-thinning medications (like aspirin, warfarin, or clopidogrel).
You have a known bleeding disorder (e.g., hemophilia or low platelets).
You experience dizziness, weakness, or fainting during or after the nosebleed.
You have underlying medical conditions like high blood pressure or liver disease.
Blood is flowing down your throat, causing coughing or vomiting of blood.
You are unable to stop the bleeding at home or feel unsure about what to do.