Nosebleed control

Authors: Simulation and Certification Center

Editor: Rednenko V.V.

Clinical situation:  

While playing football, the teenager was hit in the nose, which caused a nosebleed. You witnessed this incident and decided to provide first aid to the teenager. The scene is safe. A vehicle first aid kit is available for your use. 
Stop the bleeding.

Equipment for the practical skill:

• simulator (simalated patient);
• vehicle first aid kit.

The procedure for performing a practical skill:

• Call for help:
  • ask the bystander to bring you a vehicle first aid kit.
• Make sure the scene is safe.
• Identify a type of the external bleeding:
  • verify the bleeding;
  • choose a way to stop the bleeding.
• Since the victim is conscious, obtain informed consent to the procedure:
  • give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure;
  • explain what you are going to do;
  • ask the patient to consent to procedure.
• Tell the casualty to sit down and tilt his head forward to allow the blood to drain from the nostrils.
• Ask him to breathe through his mouth.
• Ask him to pinch the soft part of his nose for up to ten minutes, holding constant pressure. Reassure and help him if necessary.

• Advise the casualty not to speak, swallow, cough, spit, or sniff since this may disturb blood clots that have formed in the nose.
• Give him a clean cloth or tissue to mop up any dribbling.
• After ten minutes, tell the casualty to release the pressure. If the bleeding has not stopped, tell him to reapply the pressure for two further periods of ten minutes.
• Once the bleeding has stopped, and with the casualty still leaning forward, clean around his nose with lukewarm water. Advise him to rest quietly for a few hours. Tell him to avoid exertion and, in particular, not to blow his nose, because this could disturb any clots.
• If bleeding stops and then restarts, help the casualty reapply pressure.
• If the nosebleed is severe, or if it lasts longer than 30 minutes, arrange to take or send the casualty to the hospital.