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The Scenario:
It was a typical Monday morning for Karen -- rushing to get to work on time, and wishing she had had more sleep Sunday night. It wasn't that the weekend had tired her out. It was just that nagging feeling that one more weekend day would have been perfect. Eventually, two cups of coffee worked their magic, and she hopped into her car for the short ride to work. At the small intersection just down the road from her house, she took a right hand turn and noticed a young bicyclist waiting to cross the road. She stopped abruptly to let her pass. Unfortunately, the driver behind her was not paying attention. He smashed into the rear of her car, causing her to whip back, then forward into the steering wheel, face first.
Although dazed for a moment, she didn't think she was injured. That is, until she noticed the blood. Looking in the rear view mirror, she saw a big bruise developing on the bridge of her nose. She was also steadily bleeding from her nostrils.
The other driver rushed over to see how she was doing and to see if she needed assistance.
The Question:
Answer:
It's amazing how many different theories and techniques there are for trying to stop a bloody nose. You suggested everything, from lifting the upper lip in order to block the nostrils, to putting an ice pack on the back of the neck. One of our members from Malaysia said that he uses a leaf called "sirih" which is put into the nostril and apparently contains an enzyme that stimulates blood to clot. I had not heard of this. Another member wrote about a technique that always works with her kids: "Don't ask me why -- roll up a tissue or small cloth and place it between the upper lip and gums. My grandma showed me that one."
The best technique is very simple. Just hold the soft part of the nose between the thumb and forefinger, pressing firmly to close the nostrils. Steady, firm pressure for at least several minutes -- by the clock -- should be used. The head should be kept elevated to reduce the pressure within the veins in the nose. The majority of nose bleeds come from the front portion of the nose, and the bleeding can be readily stopped this way.
If you are grasping all of the soft portion of the nose and yet bleeding continues (Karen would feel it going down the back of her throat), it may be that the bleeding is coming from the back of the nose. This is much less common, but will require the attention of a doctor if it does not stop on its own within a few minutes.
Just a couple of precautions. Do not grab the bony part of the nose if there has been trauma there. In addition to being painful, you may press broken bone fragments out of alignment. One person suggested being careful about positioning the head either forward of backward in case there had been an injury to the cervical spine during the accident. I agree. Also, don't keep checking to see if the bleeding has stopped. Failure to control a nose bleed at home usually occurs because steady pressure was not applied for a long enough period of time. Ice packs applied to the bridge of the nose might theoretically cause constriction of blood vessels and lessen bleeding, but the effect is probably a minor one. Lastly, don't start blowing your nose to clear the passageways once bleeding has stopped. The blood clots in the nostrils are needed to prevent re-bleeding. Wait a few hours, at least.
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