June 15, 2010
The owner’s children are on onboard the yacht for a week of fun in the sun. Suddenly the child starts crying and running towards you with a nose bleed, also called a bloody nose.
Typically the treatment for this is simple, but yet most people get it wrong. Should they hold their head back or forward? Should they blow their nose or not? Read on to get the correct first aid treatment for a nose bleed.
Nose bleeds are common in children and young adults and in this age group they are most often a minor problem versus a medical emergency.
However no bleeding should be looked at lightly as it could be a serious problem if the bleeding does not stop.
In children and young adults the bleeding typically begins inside the septum, the piece that separates your nostrils.
In middle aged and older adults, nosebleeds can start in the septum or deeper inside the nose.
If the blood originates deeper inside the nose, care must be taken as this could be a sign of more serious medical problems such as high blood pressure or atherosclerosis - hardening of the arteries or infections.
As always, when in doubt, get professional medical advice. If you are on land, visit a doctor or clinic, if at sea and you have a telemedicine provider, contact them for advice.
Remember when your mother told you to hold your head back when you had a bloody nose? Well, Mom was wrong.
The correct steps to treating a bloody nose are as follows:
Sit down and lean slightly forward. When you sit down and lean slightly forward this prevents blood from going down your throat causing irritation and possible nausea and reduces the blood pressure inside the nose.
Lower blood pressure means less bleeding. Make certain the head is kept above the level of the heart – this helps reduce bleeding.
Apply a clean tissue or clean washcloth under your nose against the nostrils. This will help to reduce bleeding. Do not sniff, pick or blow your nose.
Apply pressure by pinching your nose. Gently squeeze the nostrils shut for 5-10 minutes. By squeezing the septum we can usually stop the bleeding. You should apply continuous pressure for at least 5 minutes before letting go. Do not sniff, pick or blow your nose.
Replace the tissue or washcloth with a clean one if the bleeding has not stopped.
Get a bucket, trash can or glass so that you can spit out any blood to prevent swallowing blood. Do not sniff, pick or blow your nose.
Slowly remove tissue or washcloth. If the nose is still bleeding apply pressure to the nose once again and continue pinching the nose for another 5 minutes.
When the bleeding stops, wash away any blood with warm water. Again, do not pick your nose, sniff or blow your nose for several hours afterward, doing so may cause the nose to bleed again.
The patient should avoid any activity during the next few hours as this too could aggravate the bleeding.
When to seek medical advice. The Mayo Clinic recommends immediate medical care when the bleeding lasts for more than 20 minutes or the nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose.
I would suggest that you also seek medical care if the patient is weak, their color does not look good – they are pale or their blood pressure or pulse are not within normal ranges.
Remember the golden rule, when in doubt call for help, get advice from a doctor.
People taking blood thinners such as aspirin or Coumadin may experience more bleeding and difficulty clotting. Ask your patient what medications they are taking as this is useful information for the doctor when treating our patient.
If you are assisting someone else that is bleeding you should always use universal precautions. Universal precautions means using the proper personal protective equipment (PPE). You should wear medical exam gloves and eye protection to prevent the possibility of contracting a bloodborne disease such as HIV or Hepatitis C.
My advice, if something is icky, sticky or wet and it’s not from your body always wear gloves and eye protection.
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