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Nosebleeds: What to Do, What Not to Do, and When to Worry

Most people manage nosebleeds wrong — tilting their head back, packing with tissue, and checking too soon. This free guide from Dr. Dylan Levy, MD, ENT Surgeon, covers the correct technique, the most common mistakes, and exactly when a nosebleed requires emergency care. Based on the AAO-HNS Clinical Practice Guideline: Nosebleed (Epistaxis).
Free Nose Bleed Guide
Two pages. Easy to understand. Backed by expert guidelines.



FAQ

No — this is the most common mistake. Tilting back sends blood down your throat, causes nausea and vomiting, and does not stop the bleed. Lean slightly forward and let blood drip out the front. The AAO-HNS guideline is explicit on this.

Lean slightly forward. Pinch the soft lower part of your nose — below the bony bridge, where both sides compress together. Hold continuously for 10–15 full minutes — set a timer and do not check early. Breathe through your mouth. Most anterior nosebleeds stop with correct technique in this time.

Go to the ER if bleeding does not slow after 20 minutes of correct compression, you are soaking through cloths rapidly, you feel dizzy or faint, your heart is racing, the bleed followed a head injury, or you are on blood thinners (warfarin, Xarelto, Eliquis, Plavix, aspirin). Posterior nosebleeds — blood coming from the back of the throat — always require emergency care.

Dry air is the most common cause, especially in winter or heated rooms. The AAO-HNS guideline recommends saline spray once or twice daily and a thin layer of petroleum jelly inside each nostril at bedtime. A humidifier also helps. If bleeding is frequent, one-sided, or hard to stop, see an ENT.

OTC oxymetazoline (Afrin) can temporarily constrict blood vessels and help stop active bleeding. The AAO-HNS guideline supports its short-term use. Do not use for more than 2–3 days due to rebound congestion risk. Avoid if you have high blood pressure, heart disease, glaucoma, or thyroid disease.

Content written by Dr. Dylan Levy, MD — Practicing ENT Surgeon, Bronx, NY. Based on: AAO-HNS Clinical Practice Guideline: Nosebleed (Epistaxis), Tunkel et al., 2020.

Medical Disclaimer

BoogerDownBronx provides general health education based on published clinical practice guidelines. All content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. The information on this site is not a substitute for professional medical care. Always consult your physician or qualified healthcare provider with questions about your medical condition. If you are experiencing a medical emergency, call 911 immediately. Content is based on guidelines published by the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), the American Academy of Pediatrics (AAP), and other relevant medical specialty organizations.