When to Worry About a Nosebleed

A bloody nose usually stops after a few minutes and is nothing serious. However, you should worry about a nosebleed if you can't stop the bleeding, have lost a lot of blood, have trouble breathing, or you're vomiting from swallowing blood. You should also get medical attention for frequent nosebleeds or a bloody nose that comes on after a serious injury.

This article discusses the cases in which you should make an appointment with a healthcare provider or go the hospital for a nosebleed. Getting care when you need it can prevent consequences of blood loss, as well as help you get a diagnosis or treatment for a potential underlying health condition.

Your Nose Bleeds Nonstop for 20 Minutes

Most healthy people should be able to stop a bloody nose at home in 20 minutes or less. Try leaning slightly forward and gently pinching your nostrils together. This helps the blood clot. It may take longer if you have a bleeding disorder.

If you have a condition like hemophilia, which causes problems with blood clotting, talk to your healthcare provider. If you are on blood-thinning medications, you should also seek medical help.

You Are Losing Too Much Blood

Excessive blood loss can make a bloody nose an emergency. Sometimes, though, it can be hard to judge how much blood you've lost. A few tablespoons can look like a lot. If you are gushing blood, call 911.

If pinching does not stop the dripping, use a container to catch the blood. A measuring cup is ideal because it will help a medical professional know how much blood you've lost.

Blood loss is most concerning if you have a history of blood diseases such as hemophilia or anemia. When you are anemic, you don't have enough red blood cells.

Prolonged nosebleeds are also a concern if you are taking medications that thin the blood, such as:

• Aspirin
• Coumadin (warfarin)
• Lovenox (enoxaparin)

Your Bloody Nose Was Caused by Severe Trauma

Trauma, especially a blow to the head, can make a bloody nose an emergency.

Minor bumps or falls that cause a bloody nose are probably not serious. Major incidents like falling down stairs, sports accidents, and fights can cause a bloody nose that becomes a medical emergency.

A severe injury to the nose may swell and make breathing difficult. You may have a broken nose, a concussion (brain injury), or a spinal cord injury. It is always best to seek emergency medical care after a major accident.

You Have High Blood Pressure

A bloody nose that is caused by high blood pressure is an emergency. These nosebleeds happen without any particular trigger.

If you get a nosebleed and you have a history of high blood pressure, contact your healthcare provider. This is especially important if you also have a headache, chest pain, or faintness.

You Can Taste Blood

Bloody noses towards the front of the nose are usually less severe. These bleeds can usually be stopped with pressure.

If you can taste blood, you may have a posterior bleed—that is, one that comes from the back of the nose.

Posterior nosebleeds are often more severe. They cannot be stopped by pinching your nostrils. They also tend to be from major blood vessels. Seek emergency care at once of you have this type of nosebleed.

You Have More Than One Nosebleed a Week

If your nosebleeds happen more than once a week, see a healthcare provider. Recurring nosebleeds can be a sign of something more serious, such as:

• High blood pressure
• A clotting disorder
• Nasal polyps
• Immune thrombocytopenia, an autoimmune condition characterized by reduced platelets
• Hereditary hemorrhagic telangiectasia, a rare genetic condition  
• Certain cancers such as leukemia, lymphoma, or nasal and sinus cancer
  

Summary

Bloody noses are usually not serious. Most can be stopped if you lean forward and gently pinch your nostrils.

In some cases, a bloody nose can be an emergency. If your nose bleeds for longer than 20 minutes or you lose a lot much blood, get emergency help. You should also seek emergency care if you were in a serious accident, have high blood pressure, or can taste blood.