Bleeding from the nose most commonly occurs when the fragile blood vessels inside the nose ruptures either by a blow to the nose, or by sneezing, picking or blowing the nose. Nose bleeds may also occur due to high blood pressure.

Majority of nosebleeds are nothing serious and are usually self limiting given the appropriate first aid. But a nose bleed can be dangerous if the casualty looses alot of blood or if the bleeding follows a head injury and the blood appears thin and watery – this is a sign that the skull is fractured and the fluid from around the brain is leaking out.

Action

Ask the casualty to sit down.

Advise her to tilt her head forward to allow the blood to drain from the nostril and not to allow blood to drain backwards in to her throat. 

Ask casualty to breathe through her mouth (this will also have a calming effect) and to pinch the soft part of the nose. Reassure and help her if necessary. 

Tell casualty to keep pinching her nose.  

Advice her not to speak, swallow, cough, spit or sniff as this may disturb the blood clots that have formed in her nose to stop the bleeding.

Give her a clean cloth to wipe off any dribbling.

Pinch for 10 minutes. Then release pressure.

If bleeding has not stopped then reapply the pressure again for another 10 minutes. 

Once bleeding has stopped, and with the casualty still leaning forward, clean around nose with tap water. 

Advise casualty to rest quietly for a few hours.

Tell her to avoid exertion and in particular, not to blow her nose, because these actions will disturb any clots. 

Caution

Do not let head tip back; blood may run down the throat and cause vomiting. 

If nose bleed is severe, or if it lasts for more than 30 minutes in total, take or send to hospital in the treatment position.

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