Red flags & when to go in person for Nosebleed (Epistaxis) - Triage

Audience: adult

Nosebleeds, or epistaxis, are common and often not serious. They usually stop on their own or with simple first aid, such as pinching the nose and leaning forward. However, some nosebleeds may signal a more serious problem and require in-person medical care. This guide helps adults understand when to seek urgent care for a nosebleed. Warning signs include heavy bleeding that lasts more than 20 minutes despite first aid, bleeding after an injury to the head or face, or if you feel very weak or dizzy. Telemedicine can help assess mild nosebleeds and advise on basic care, but it cannot replace hands-on treatment needed for severe or ongoing bleeding. Knowing the red flags and when to get in-person care can help keep you safe and ensure you get the right treatment at the right time.

Red flags — go in person / ER

• Nosebleed lasting more than 20 minutes despite applying firm pressure — seek emergency care immediately.
• Nosebleed following a head or facial injury — go to the emergency department for evaluation.
• Feeling faint, weak, or having difficulty breathing during or after a nosebleed — seek urgent medical attention.

What telemedicine can do

• Assessing mild, short-lived nosebleeds.
• Providing advice on first aid and prevention of nosebleeds.
• Guidance on when to seek in-person care.
• Answering questions about medications or underlying conditions related to nosebleeds.

What telemedicine cannot do

• Treating heavy or ongoing nosebleeds requiring physical intervention.
• Evaluating nosebleeds caused by trauma or injury.
• Managing severe symptoms like difficulty breathing or fainting.
• Performing diagnostic procedures or blood tests.

What is a Nosebleed (Epistaxis)?

A nosebleed happens when blood vessels inside the nose break and bleed. It can occur from dry air, picking the nose, injury, allergies, or infections. Most nosebleeds come from the front part of the nose and stop quickly with simple care.

Common Causes of Nosebleeds

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When to Use Telemedicine for Nosebleeds

Telemedicine can help if your nosebleed is mild and stops quickly. A healthcare provider can guide you on how to manage it at home, check for risk factors, and advise if you need to seek in-person care. It is useful for follow-up questions or concerns after a nosebleed.

When to Seek In-Person Medical Care

Go to a healthcare facility if you experience:

How to prepare for your tele-visit

• Have a quiet, well-lit place for your telemedicine visit.
• Be ready to describe your nosebleed: duration, amount of bleeding, and any triggers.
• Know your medical history, including medications and bleeding disorders.
• Have a family member or friend nearby if you feel weak or dizzy.
• Prepare to show your nose area on camera if asked by the provider.

After your tele-visit

• Follow the healthcare provider’s advice on nosebleed care and prevention.
• Avoid picking or blowing your nose forcefully for several days.
• Use a humidifier or saline nasal spray if recommended to keep nasal passages moist.
• Monitor for any new or worsening symptoms and seek care if red flags appear.
• Schedule follow-up appointments if advised by your healthcare provider.

FAQs

How can I stop a nosebleed at home?

Sit down and lean slightly forward to avoid swallowing blood. Pinch the soft part of your nose firmly for at least 10 minutes without releasing pressure. Breathe through your mouth during this time. Applying a cold compress to the nose or cheeks may help.

What should I avoid after a nosebleed?

Avoid picking or blowing your nose forcefully for several days. Also, try not to bend over or lift heavy objects as this can increase pressure in your nose and cause bleeding to restart.

Can medications cause nosebleeds?

Yes, medications like blood thinners (e.g., warfarin, aspirin) and nasal sprays can increase the risk of nosebleeds. If you suspect your medication is causing frequent nosebleeds, talk to your healthcare provider.

When should I worry about frequent nosebleeds?

If you have nosebleeds that happen often without clear cause or last longer than usual, it is important to see a healthcare provider for evaluation. This may signal an underlying health issue.

Is it safe to use telemedicine for nosebleeds?

Telemedicine is safe for mild nosebleeds and can provide helpful advice. However, if your nosebleed is heavy, lasts a long time, or you have other serious symptoms, you should seek in-person medical care immediately.

Sources

1. Epistaxis (Nosebleed) — MedlinePlus, U.S. National Library of Medicine / NIH.
2. Nosebleeds (Epistaxis) — Mayo Clinic.
3. Epistaxis — Centers for Disease Control and Prevention (CDC).
4. Nosebleeds — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care. If you experience severe symptoms or red flags, seek immediate medical attention.