Coping with nosebleeds - For people with bleeding disorders

For people with bleeding disorders

Many people have nosebleeds. People with a bleeding disorder have them more often. They can be made worse by dry winter air, humid summer air. Environmental allergies, like pollen or ragweed can also cause nosebleeds. They are also worse from picking, bumping or rubbing the nose. For many, a nosebleed goes away in a few minutes. For others, they happen a lot, last a long time or are heavy. This can affect daily life.

How can they be prevented?

• Use a humidifier at night. Be sure to follow the cleaning guidelines for the humidifier.
• Use saline nasal spray or gel 4 times each day. Some over-the-counter brands include:
• Ayr Saline™ nasal Gel  
• Ayr Saline™ Natal mist • Little Noses® Saline Mist
• Ocean® nasal spray
• Put petroleum jelly or olive oil inside the nose gently with a cotton swab.  Do this a few times each day. Triple antibiotic ointment can be used for up to 2 weeks.
• If you have allergies, use antihistamines as directed by your healthcare provider.
• Do not pick your nose.
• Blow your nose gently.

How are they treated?

If you have frequent, heavy, or nonstop nosebleeds: 

1. Pinch your nose firmly just under the bony ridge for 15 minutes. Do not peek before the time is up.
a. If it still bleeds after the 15 minutes, pinch again for another 10 minutes. Remember, do not peek early. To help pinch the nose and still keep both hands free, a nose clip can be used.
b. Do not lie down or tilt your head back. Try to tilt your head slightly forward. You do not want blood to run down the back of your throat into your stomach. Blood in the stomach may make you vomit. If you taste blood in your mouth, gently spit it out.

2. If pinching does not stop the nosebleed, try these things: 

• Put an ice or cold pack in a washcloth and put it on the bridge of the nose.  
• Afrin nasal spray (regular strength). Spray on a cotton ball so it is wet and put it in the nostril that is bleeding. Hold for 10 minutes. You can repeat this every 10 minutes for up to 3 times to help the bleeding to stop. Do not use Afrin for more than 3 days in a row. 
• WoundSeal® Powder for Nosebleeds. (Formerly called Nosebleed QR™). This powder mixes with blood to form a flexible scab over the bleeding area. It can be bought at many drug stores without a prescription. To learn more about this product or where to buy it, visit the company’s website at www.woundseal.com.  
  – This powder can cause a burning feeling when the powder is used. To help decrease the burning, put WoundSeal on only when there is active bleeding.  
• NasalCEASE®. This product contains calcium alginate. It helps the body make a clot by reacting with the sodium that is in the blood.  It also jellifies. This lets you take it out of the nose without disturbing the clot that has formed. It is sold at most drug stores. A prescription is not needed. To find out more about the product visit the company’s website at www.NasalCease.com.
• Quick Seal® Nosebleed Kit.  This kit contains nasal plugs. The plugs are sponges that absorb blood. The sponges also contain an ingredient to help stop bleeding. They are nonstick and can be easily removed from the nasal cavity. This reduces the risk of renewed bleeding. This kit can be purchased at most drug stores. A prescription is not needed.

If the above measures are not effective, you may need to talk with a medical professional. Medicines your doctor may prescribe are:

• IV Desmopessin (DDAVP) This medicine is given in a hospital and is used to stop bleeding episodes.  It can only be used in patients with certain bleeding disorders.    
• Amicar®. This is an oral medication that comes in pill and liquid forms. It may not immediately stop a nosebleed but it may decrease the frequency of nosebleeds.  Amicar can also be applied to a gauze pad and applied directly to the inside of the nose to help stop bleeding. Saturate gauze in liquid and pack into affected nostril. Remove after 20 minutes.Lysteda®.  This works just like Amicar but only comes as a pill.  It is used the same way as Amicar.
• Estrogen cream.  This cream thickens tissues inside the nose and helps prevent bleeding.
• Remember, after a nosebleed stops, do not blow or pick your nose. It will loosen the clot and the bleeding may start again.  

If you have questions about this information, please call your Comprehensive Center for Bleeding Disorders (CCBD) Nurse Coordinator.    
CCBD - Phone: (414) 257-2424 or (888) 312-CCBD.

ALERT

Call your child’s doctor, nurse, clinic or the CCBD if you have any questions or concerns or if your child has:

• A nosebleed that continues to bleed after 2 rounds of pinching. Continue to have your child lean forward and press the nostrils together as you call.
• Swelling or deformity following an injury to the nose.
• Special health care needs that were not covered by this information.