When is a Nosebleed an Emergency?

As an ear, nose and throat specialist and former corner cut man for boxing legend Vinny Paz, I've treated more than my fair share of bloody noses over the years. Blood vessels in the nose are highly sensitive, making them more susceptible to bleeding, particularly in older adults. Using petroleum jelly or a non-medicated saline spray can help prevent nasal dryness and bloody noses.

While nosebleeds are common, they can be frightening, and in rare cases, life-threatening. Nosebleeds typically occur during dry, colder weather, but they also can occur in hot, arid climates. Additionally, nosebleeds can be triggered by trauma (including nose-picking), as well as colds, allergies, hypertension and blood thinners.

When is a bloody nose an emergency? It depends on the amount of blood coming out of your nose and whether it responds to the conventional treatment method. Obviously, there's a big difference between a minor trickle and a major gusher.

If you have a nosebleed, you don't want to tilt your head back, as this will cause the blood to run down the back of your throat. Instead, you want to tilt your head slightly forward and pinch the nostrils together for five minutes. If the bleeding hasn't stopped after this time, continue squeezing the nose for an additional 10 minutes. You also can apply an icepack to help halt the flow of blood.

The general rule is if the bleeding hasn't stopped after 15 minutes of pressure, or if you have bled half a cup or more (the rough equivalent of two soaked wash cloths), you should head to the ER to have your nose properly evaluated by a doctor.

Frequent nosebleeds can sometimes signal serious health conditions, so it's important to consult your physician if you're experiencing them at an abnormal rate.

-- Dr. Andrew Ordon

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