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When is a Bloody Nose a Medical Emergency?

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Updated June 02, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: When is a Bloody Nose a Medical Emergency?
Bloody noses are common and caused by a variety of factors including dehydration and dry air, sinusitis, allergies, blood thinning medications and trauma. When does a simple bloody nose become a full-blown emergency?
Answer:

When You've Been Unable to Stop Your Bloody Nose After About Twenty Minutes

For most healthy individuals you should be able to stop a bloody nose at home in about twenty minutes. If you have a bleeding disorder it may take longer; you should talk to your doctor about methods and wait times when it comes to bloody noses.

When You're Losing Too Much Blood

Too much blood loss can make a bloody nose an emergency. In the medical profession we sometimes say that 5 milliliters of blood looks like 30! It's true, if you're judging by the amount of blood on your shirt, it may look like you need a transfusion when you've really lost no more than a few tablespoons. If you're gushing blood, however, you need to call 911.

The best thing to do when you get a bloody nose is to lean forward and gently pinch your nostrils together with a clean tissue. This facilitates clotting. If it's still dripping, however, grab a container to catch the blood. If possible this container should be a measuring cup. This allows you to accurately describe your blood loss to medical personnel. Blood loss will be of most concern in individuals who have a history of blood diseases such as anemia or hemophilia, or who have been taking medications that thin the blood such as aspirin, Coumadin (warfarin), or lovenox. So how much blood is acceptable to lose? That depends on your overall health and whether you're having symptoms of anemia. It's best to consult your doctor with a good idea of how much blood you've actually lost.

Symptoms of too much blood loss (anemia) include:
  • fatigue
  • feeling dizzy or light-headed
  • pale skin color
  • confusion
  • rapid heartbeat
  • chest pain

If you have any of these symptoms you should consult your doctor immediately.

When Your Bloody Nose Was Caused by Severe Trauma

Trauma, especially a blow to the head, can make a bloody nose an emergency. We've all been bumped in the nose, or fallen down and gotten a minor bloody nose, but that's not what I'm talking about. If you've fallen down the stairs, collided with another individual or been in a skiing accident, fight, or other traumatic incident that has resulted in a bloody nose, you could have a very serious medical emergency on your hands. What starts out as a bloody nose, with a little bit of time and swelling, may soon make it almost impossible to breathe. That's not even to mention possible fractures (ie. broken noses), concussions or spinal cord injuries. Just do yourself a favor and get some emergency medical care.

When You Suspect High Blood Pressure Caused Your Bloody Nose

A bloody nose becomes an emergency when it is caused by high blood pressure. If you have a history of high blood pressure, or if the bloody nose is accompanied by a pounding headache or mental confusion, contact your doctor.

Source:

Medline Plus. Nosebleed. Accessed: December 7, 2010 from http://www.nlm.nih.gov/medlineplus/ency/article/003106.htm

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