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Nosebleed (epistaxis)

Epistaxis · Krvácení z nosu (epistaxe)

What it is

Most nosebleeds come from a web of small vessels at the front of the septum (Little's area); dry air, picking and blood thinners set them off.

Symptoms & signs

  • Bleeding from one nostril
  • blood running down the throat
  • repeated bleeds in winter
  • dizziness if heavy

🚩 Get help if…

  • call 112 / 911 now Bleeding over 20 minutes despite pinching the nose
  • call 112 / 911 now Heavy bleeding with dizziness, fainting or trouble breathing
  • see a doctor soon Bleeding after a head injury or on blood thinners
  • see a doctor soon Frequent nosebleeds or blood only ever from one side

Where it strikes

Medical treatment

  • Sit up, lean forward, pinch the soft nose firmly for 10–15 minutes
  • ice on the bridge of the nose
  • antiseptic nasal cream
  • silver nitrate cautery
  • nasal packing or tying the artery for severe bleeds
  • tranexamic acid (topical: no benefit in the NoPAC trial)

Natural & lifestyle

  • Humidifier and saline gel in dry weather
  • stop picking
  • review aspirin and blood thinners with the doctor

Emerging & experimental

  • Haemostatic gels and matrices (Floseal)
  • bevacizumab or tacrolimus in hereditary telangiectasia (HHT)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Tranexamic acid on the nasal lining — some trials positive, the large NoPAC trial (2021) found no benefit mixed evidence
  • A cold key down the back of the neck — folklore anecdotal / traditional
  • Tilting the head back — harmful: you swallow blood and may vomit anecdotal / traditional

ICD codes