Consultant ENT, Head and Neck and Thyroid Surgeon

NOSEBLEEDS (or EPISTAXIS)

Most nosebleeds are short-lived, and usually stop on their own or by pinching the nose - this is best done by leaning forward over a bowl or sink and pinching the front (flexible) part of the nose on both sides between thumb and forefinger, closing the nostrils so that you have to breathe through the mouth.

Do this for 10 to 15 minutes, and an ice pack (or packet of frozen peas) held over the nose and face often helps. Sucking an ice-cube at the back of the mouth may also help to stop the bleeding. Once the bleeding stops, don’t blow the nose for 24 to 48 hours as if you do you risk dislodging the clot that has plugged the bleeding blood vessel.

Avoid hot and/or spicy food and drinks and hot showers or baths for a similar time period. However, if the bleeding is heavy and prolonged (i.e longer than 20 minutes or so) you should seek help, and the best thing to do is to go to your local Accident and Emergency
Department.

If the nosebleeds are intermittent but controllable, then it is best to be examined by and Ear, Nose and Throat Consultant as
soon as possible in outpatients before the bleeding recurs.

I will be able to look into your nose with an endoscope (very fine fibreoptic camera) at the time of your appointment and often be able to see where the bleeding is coming from straight away.

If this is the case, I can usually painlessly cauterise the area where the bleeding is coming from with a silver nitrate matchstick or electrocautery, with instant cessation of the nosebleeds.

If this is not possible, I can offer you surgical treatment for the problem without delay – this may involve a septoplasty to straighten your nasal partition, with or without a procedure done endoscopically up your nose to tie off the offending blood vessel, called Sphenopalatine Artery Ligation (SPA Ligation).