Should You Tilt Your Head Back or Forward to Stop a Nosebleed?

Most people's first reaction to a nosebleed is to tilt their head back to avoid dripping blood. However, experts say it is best to sit up straight and keep your head in a neutral position.

A nosebleed (epistaxis) is a fairly common problem that is often treated at home. Nosebleeds occur when small, fragile blood vessels in the nose rupture. This can be due to injury, allergies, air quality, altitude, or an underlying medical condition.

This article explains why you shouldn't tilt your head back with a nosebleed. It also provides step-by-step first aid instructions for treating a bloody nose at home and details for when a nosebleed requires medical attention.

Why You Shouldn't Tilt Your Head With a Nosebleed

Tilting your head back will reduce the amount of blood that comes out of your nose, but the blood has to go somewhere. Tilting your head back directs the blood down your throat instead. This can cause in nausea, vomiting, and diarrhea.

You should also avoid tilting your head forward too much. A slight tilt forward is OK, but avoid leaning down to your knees. This positions your heart above your head, which can encourage more bleeding.

While putting your head between your knees is common first aid for dizziness, it is not a good idea for nosebleeds.

When working to stopping a nosebleed, it is best to keep your head in a neutral position.

What to Do When You Have a Nosebleed

Rather than tilt your head back, the recommendation is to:

1. Sit in a chair.
2. Keep your body and head upright rather than tilted backward or bent far forward.
3. Pinch your nostrils together by gently pressing on each side of your nose (just below the bridge).
4. Keep pressure on your nostrils for at least five minutes—ideally a full 10 minutes, if possible—before checking to see if bleeding has stopped.

If available, you can use a cloth or tissue to catch any blood, but don't pack your nose with gauze or tissue. You can apply a cold compress to the bridge of your nose if helpful.

After the bleeding stops, maintain an upright body position and avoid bending over. Avoid blowing your nose as well.

You may need to make a few attempts to stop your nosebleed. The entire process may take between five and 20 minutes. Nosebleeds that continue longer than 20 minutes require medical attention.

When to See a Healthcare Provider

If you have a nosebleed that you managed to stop, contact your healthcare provider for further advice if you are taking anticoagulants (blood thinners), you started a new medication recently, you recently had nasal or sinus surgery, or you have a known condition such as a nasal or sinus tumor or polyps.

Nosebleeds are rarely a medical emergency. However, there are times when you may need help from a medical professional.

You can determine the severity of your nosebleed by asking yourself the following questions. If you answer "yes" to any of these, seek medical attention immediately:

• Has your nose been bleeding for 20 minutes and won't stop despite you trying the first aid steps listed above?
• Are you bleeding rapidly or have you lost more than a cup of blood?
• 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)
• Is the bleeding caused by a traumatic facial injury (like a broken nose), a car accident, or a blow to the head?
• Are you taking anticoagulants (blood thinners)?

Medical Treatment for Nosebleeds

When you can't control a nosebleed on your own, a healthcare provider can use a medical intervention to do so.

Some common options that may be considered include:

• Silver nitrate cauterization
• Nasal packing
• Nasal clip
  

Preventing Future Nosebleeds

Genetic causes of nosebleeds, like hereditary hemorrhagic telangiectasia, are obviously unavoidable. And if you are on a blood thinner, which impedes clotting, you may not be able to stop taking your medication.

But most other causes of nosebleeds can be influenced by changes that are within your control:

• Refrain from picking your nose and keep nails short with rounded edges.
• Work to manage your allergies and do your best to prevent colds to avoid having to blow your nose frequently.
• Try using a cool mist humidifier at night, particularly if you live in an area with low humidity.
• Use a saline nasal spray to keep your nasal passages hydrated.

If you play sports or have a physical job, be sure to wear proper protective equipment (if applicable) to prevent facial trauma.

That said, some people experience frequent nosebleeds that sometimes don't have an obvious cause (such as being bumped in the nose).

You can often stop these nosebleeds, but to further prevent them from recurring, you should talk to your healthcare provider.