Should I Tilt My Head Back to Stop a Nosebleed?

Have you ever been told that you should tilt your head back when you have a nose bleed? I have, and while it may reduce the amount of visible blood coming out of your nostrils tilting your head back allows the blood to run down the back of your throat instead of out of your nose. Complications that can arise from blood running down the back of your throat include:

• Coughing
• Choking
• Vomiting if blood enters the stomach

The good news is that nosebleeds are fairly common and rarely an emergency. However, on occasion, you may need help from a medical professional for your nosebleed.

Prior to attempting to stop a nosebleed on your own, you should first determine if the nosebleed is actually a medical emergency due to the severity of the nosebleed. You can determine the severity of your nosebleed by checking the following:

• Is the bleeding caused by a traumatic facial injury like a broken nose?
• Did you just have nasal or sinus surgery?
• Do you have a known tumor or growth in your nose?
• Are you having other symptoms as a result of the bleeding, such as pale skin, confusion, chest pain or difficulty breathing?
• Is blood running down the back of your throat? (posterior nosebleed)

If you answer yes to any of the above questions, you should seek medical attention immediately. Do not drive yourself to an emergency room or doctor's office. Driving while you are actively bleeding could result in passing out at the wheel and being involved in a dangerous accident. Instead, call 911 or ask a friend or family member to drive you to the emergency department.

The best solution for a nosebleed with complications related to the questions above is to call 911.

You should first remain calm. Getting upset and nervous may cause actions that will cause further irritation in the nose and prevent clotting.

In order to properly stop a nosebleed, you need to pinch your nostrils together by gently pressing on each side of your nose (just below the bridge of your nose or the bony portion) while leaning slightly forward to prevent blood from running down the back of your throat. Keep this pressure on your nostrils for a full 10 minutes if possible. If available you can use a cloth or tissue to catch any blood. You may need to make a few attempts and the entire process may take between 5 and 20 minutes. 

Nosebleeds that continue longer than 20 minutes may require medical attention.

Some people experience frequent nosebleeds that sometimes don't have a clear cause (such as being bumped in the nose). Here are some causes of this type of frequent nosebleeds:

• Genetic causes like hereditary hemorrhagic telangiectasia
• Previous, untreated facial trauma
• Blood thinners
• Picking your nose; out of habit or related to allergies or nasal dryness

Any of the above-mentioned items can lead to having frequent nosebleeds. You can often stop these nosebleeds, however, to further prevent them from recurring you should be evaluated by an otolaryngologist or ENT physician.

If you live in a dry area of the country with low humidity you may first want to try using a cool mist humidifier next to your bed at night or using a saline nasal spray since dryness is a very common cause of frequent nosebleeds.

In order to control a nosebleed that can't be stopped on your own, a physician will use the most appropriate therapy for the severity of your nosebleed. Common interventions include:

• Cauterization
• Nasal packing
• 4% cocaine solution

• Use a humidifier, particularly in the winter months when the humidity is low
• Keep nose moist with products like antibiotic ointment (ask your doctor first), petroleum jelly, vitamin A & D ointment, or nasal saline sprays
• Avoid picking your nose and keep nails short and neatly trimmed without sharp edges