Is it right to tilt your head back and stuff toilet paper into your nose to stop the bleeding when you have a nosebleed?

Author: Yin Jinshu, Chief Physician, Beijing Century Altar Hospital, Capital Medical University

Reviewer: Liu Yuhe, Chief Physician, Beijing Friendship Hospital, Capital Medical University

Vice Chairman of the Science Popularization Branch of the Chinese Medical Association

Nosebleeds are very common, with 60% of people experiencing them in their lifetime. When a nosebleed occurs, most people will involuntarily tilt their heads back and stuff toilet paper into their nostrils to stop the bleeding. Is this correct?

This is not the right way to do it. When you have a nosebleed, it is not recommended to tilt your head back or plug your nostrils with toilet paper.

1. Why is it not recommended to tilt your head back or stuff your nose with toilet paper when you have a nosebleed?

If you tilt your head back when you have a nosebleed, the blood in your nasal cavity will easily flow back into the nasopharynx and be easily swallowed. Swallowing too much blood will irritate your stomach.

The correct approach should be to tilt the head slightly forward to allow the blood to flow out. This way, the blood will not flow into the nasopharynx, block the respiratory tract, or be swallowed into the stomach. It can also determine the amount of bleeding.

Figure 1 Original copyright image, no permission to reprint

If you use toilet paper to pack the nasal cavity, it will break easily after being soaked in blood, and it is not easy to remove after breaking, and it will remain in the nasal cavity and block the respiratory tract. Therefore, it is recommended to use cotton wool to pack the nasal cavity to stop bleeding when the nose is bleeding.

If you have topical nasal medication at home, such as oxymetazoline, which is a decongestant, soak cotton wool with oxymetazoline and then insert it into the nasal cavity, this will have a better effect in stopping bleeding. If you don't have cotton wool at home, you can also use makeup remover cotton wool in an emergency.

2. In addition to the above hemostatic measures, what other methods can be used when nose bleeding occurs?

Finger pressure method: pinch the nose wing with the thumb and index finger, and squeeze it towards the nasal septum. The anterior and lower part of the nasal septum is the most common bleeding site. Pressing for 5-15 minutes can achieve the purpose of stopping bleeding.

Figure 2 Original copyright image, no permission to reprint

Cold compress method: Soak a towel in cold water and place it on the forehead or neck to cause local blood vessels to contract and achieve the purpose of stopping bleeding.

After taking the above hemostatic measures, if nose bleeding cannot be controlled, go to the hospital as soon as possible.

While doctors are trying to stop the bleeding, they also need to find out the cause of the bleeding.

3. What are the causes of nosebleeds?

Nosebleed is a phenomenon or symptom. There are many reasons that can cause nosebleed, including local, systemic, and environmental factors.

Local causes, such as nasal inflammation, deviated nasal septum, nasal trauma, nasal foreign bodies, and malignant tumors of the nasal cavity and paranasal sinuses.

Nosebleeds caused by local factors may be a small amount of bleeding, blood in the nasal discharge, or some blood in the sputum in the morning. Sometimes it is fresh blood, flowing out completely from the front nostrils, or flowing into the pharynx, manifesting as vomiting blood. Nosebleeds caused by local factors may also be accompanied by other symptoms, such as nasal congestion, runny nose, headache, and decreased sense of smell.

Systemic causes, such as:

Hypertension and increased venous pressure. Pulmonary heart disease, chronic bronchitis, masses in the chest, mediastinum, and neck compress the venous system, affecting the venous return of the head and face, leading to increased venous pressure;

Coagulation disorders, thrombocytopenia;

Fever, such as infectious fever, rheumatic fever, etc., accelerates blood circulation, leading to dry nasal mucosa;

Liver function damage, such as chronic hepatitis, cirrhosis, decreased coagulation factors synthesized by the liver, and coagulation dysfunction;

Chronic nephritis, renal failure, chronic vascular damage, and abnormal coagulation factors and coagulation mechanisms;

Endometriosis, such as endometriosis to the nasal cavity;

Genetic disorders, such as hereditary hemorrhagic telangiectasia, in which the capillaries in the nasal septum are abnormally dilated;

Taking certain medications, such as anticoagulants and long-term use of low-dose aspirin, can prolong blood clotting time.

Nosebleeds caused by systemic factors may be a small amount of bleeding, with bloody nasal discharge, or a large amount of bleeding. The biggest feature is that it is accompanied by some symptoms of the corresponding disease, and nosebleed is just one of many symptoms.

There are many reasons for nosebleeds. When nosebleeds occur, if the bleeding stops using the above methods, is it still necessary to go to the hospital?

It is recommended to go to the hospital for treatment and let the doctor determine the cause of the nosebleed. After finding out the cause and actively treating it, the chance of re-bleeding can be reduced.

For example, patients with deviated nasal septum will have their nasal mucosa become thinner and thinner as they age. Coupled with arteriosclerosis and high blood pressure, the probability of nosebleeds becomes higher and higher. Nosebleeds are especially likely to occur in winter, and only corrective surgery for deviated nasal septum can solve the problem of nosebleeds.

For healthy people, nosebleeds can occur even without the local factors and systemic disease factors mentioned above, because there are also environmental factors. To prevent nosebleeds, it is important to maintain the humidity of the air, especially in the north. When the heating comes on in winter, the nasal mucosa will become dry and prone to bleeding. It is recommended to use a humidifier.