Nosebleeds often look worse than they are. When stopping a nosebleed, many affected people decide to put their head back into the neck. However, this is an absolutely wrong measure.
The bleeding is increased and the blood can run down the throat. There is a high risk of it being swallowed and getting into the stomach, which can lead to nausea and vomiting. Another danger regarding this wrong measure is in unconscious patients, because the blood can get into the respiratory tract.
Instead, as a first measure, the head should be tilted slightly forward and hung loosely. This will reduce the blood pressure. In order to stop the nosebleed quickly, the nostrils should be compressed with the fingers directly below the nasal bone, because the source of bleeding is usually at the tip of the nose.
After five to ten minutes you can try to reduce the pressure gradually and observe whether any blood is still coming out of the nose. Also the so-called ice tie often provides relief. To do this, place a cooling pad or a wet, cold cloth in the neck.
An alternative position for cooling is the forehead. The cool pack or ice cubes should always be wrapped in a cloth to prevent skin freezing. This method causes the vessels of the nose to contract reflexively and the bleeding is stopped.
If you notice nosebleeds, it is important to stay calm. If this does not happen, the blood pressure rises even further and the bleeding is intensified. If these methods do not work and the nosebleed cannot be stopped within 15 to 20 minutes, an ear, nose and throat doctor should be consulted. If the bleeding comes from both nostrils, a doctor should also be consulted.
Home remedies
An old household remedy is to put cellulose or blotting paper under the tongue. A quarter of a handkerchief, for example, is well suited for this. Sucking a slice of lemon should also help some people.
This method is often used by athletes. The dry cloth under the tongue is perceived by the body as foreign and then the body tries to push the foreign body away, which causes more saliva to be produced to insalivate the foreign body. In addition to the increased saliva production, the blood flow to the area under the tongue is increased, which results in less blood flow to the nose and the nosebleed stops faster.
However, the effectiveness of this method has not been scientifically proven. As an alternative to compressing the nostrils, a cotton swab is often inserted into the front part of the nose. The cotton swab can then stop the bleeding from the inside.
It should be possible to remove it again after about ten minutes. To protect the mucous membrane, the cotton swab is greased with skin cream. Cotton swabs can stick to the mucous membrane if they are not removed early enough.
If the cotton swab is removed, the wound may tear open again. Therefore, compression of the nostrils is the better alternative. Many doctors advise against the absorbent cotton method for this reason.
However, there are also so-called “haemostatic absorbent cotton”, which has blood-clotting properties and is recommended for nosebleeds. If the nosebleed cannot be stopped by conventional means, the ENT physician can perform a nasal tamponade. A distinction is made between an anterior and posterior tamponade, which is also called a Belocq tamponade.
A tamponade is a absorbent cotton compress. An anterior tamponade is usually performed when the bleeding is caused by the so-called locus kiesselbachii. This is a vascular plexus located at the tip of the nose.
A compress is usually used for the tamponade, which is pushed into the main nasal cavity. The tamponades should always be made on both sides, so that a counter pressure can be exerted through the other side. After two to three days, the anterior nasal tamponade is removed.
Afterwards, the mucous membrane of the nose should be well cared for. The posterior nasal tamponade, on the other hand, is made in the case of severe nosebleeds from the posterior nasopharynx when bleeding from the sphenopalatina artery. These bleedings are more severe than bleedings from the front part of the nose, because the vessels in the nasopharynx are not as finely branched and therefore have a larger diameter.
These bleedings cannot be stopped by an anterior nasal tamponade. The Belocq tamponade is usually performed under local anesthesia, sometimes also under general anesthesia. For the tamponade, a catheter is inserted through the nose into the throat and then pulled out of the mouth with forceps.A thread is attached to the catheter, which is connected at the other end with a foam pad.
The catheter is then pulled out again over the nose so that the tampon can reach the nasopharynx and close the posterior nasal opening (choanas) there. The thread is then fixed to the nose. At the same time, another anterior tamponade is performed so that the cavity of the nose is closed from the front and back and the bleeding is stopped in any case. The posterior tamponade usually remains for a period of two days. Due to the danger of infection in the posterior tamponade, an antibiotic is administered prophylactically.