During a nosebleed, blood flows from one or both nostrils and can last from a few seconds to over 10 minutes.

Nosebleeds can be caused by a number of different factors which are not always easy to identify.

Nosebleeds can start just inside your nostrils (anterior) or at the back of your nostrils (posterior). Anterior and posterior nosebleeds usually have different causes.

The most common place for a nosebleed to start is just inside the nostrils by the septum (middle of the nostrils).

This is due to the delicate blood vessels inside your nose becoming damaged.

This can happen easily and the most common causes for anterior nosebleeds include:

• Picking your nose.
• Blowing your nose very hard.
• A minor injury to your nose.
• Colds and stuffy noses, such as when you have hay fever.
• Changes in humidity or temperature causing the inside of the nose to become dry and cracked.
• Cocaine use.

Sometimes, bleeding can come from the blood vessels deeper inside the nose.

Bleeding can be caused by a number of things including:

• Medication such as aspirin and other blood thinners.
• Medical conditions such as haemophilia or Von Willebrand disease.
• A blow to the head.
• Recent nasal surgery.
• High blood pressure and atherosclerosis (hardened arteries).

Posterior nosebleeds are much less common and usually affect older adults. They can be serious because the blood flow is heavy.

When you have a nosebleed there are some simple steps you can take to help it stop:

1. Sit down and firmly pinch the soft part of your nose, just above your nostril openings, for 10 to 15 minutes.
2. Lean forward and breathe through your mouth – this will drain the blood down your nose instead of it going down the back of your throat.
3. Place an ice pack or bag of frozen vegetables covered with a towel on the bridge of your nose.
4. Do not lie down, as this will increase the pressure in the blood vessels of your nose.

• Avoid hot drinks, hot baths, alcohol, smoking, straining on the toilet, heavy lifting and exercise for a few days.
• Avoid both blowing your nose and picking the scab.
• Avoid nasal sprays if not prescribed by a healthcare professional.

If after 20 mins your nose is still bleeding heavily you should go to your nearest Emergency Department.

Usually the bleeding will stop if you have followed the advice in this leaflet. No further treatment will be needed however, please contact your GP or NHS 111 if:

• You have had several nose bleeds over the last few days.
• You are taking blood thinning (anticoagulant) medication.
• If you have a severe nose bleed or feel unwell (e.g. dizzy, lightheaded, palpitations) phone 999 and request an Ambulance.

Bradford Royal Infirmary; Emergency Department: 01274 272747
Or contact your GP.