Nosebleeds: Causes, First Aid & When to See a Doctor

Epistaxis affects 60% of people lifetime; 10% seek care. 90% anterior (Kiesselbach's plexus).

Common Triggers

• Dry air, nose picking, trauma, URI, allergies.
• Anticoagulants, antiplatelets, NSAIDs, intranasal steroids.
• HTN, atherosclerosis, hereditary hemorrhagic telangiectasia.

First Aid

1. Sit, lean forward.
2. Pinch soft nose 10–15 min (timer).
3. Ice to bridge.
4. If stops: no blowing, bending, heavy lifting ×24h.

Seek Care If

• >20 min active bleeding.
• >1 cup blood loss.
• Posterior bleed signs.
• On warfarin/DOAC with INR>3 or DOAC within 24h.
• Recurrent (>2/week).

Prevention

• Saline spray/gel BID.
• Humidifier 40–50%.
• Petrolatum to anterior septum nightly.
• Treat allergic rhinitis.