Immediate Management of Nasal Trauma
Apply firm, sustained compression to the soft lower third of your nose for a full 10-15 minutes without checking if bleeding has stopped, sit upright with your head tilted slightly forward, and breathe through your mouth. 1, 2
First-Line Actions Right Now
- Position yourself sitting upright with head tilted slightly forward to prevent blood from flowing into your airway or being swallowed 1, 2
- Apply continuous, firm pressure by pinching the soft lower part of your nose (not the bony bridge) for a minimum of 10-15 minutes without interruption 1, 2
- Do not check if bleeding has stopped during this time period, as releasing pressure prematurely prevents clot formation 1, 2
- Breathe through your mouth and spit out any blood rather than swallowing it 1, 2
If Bleeding Continues After 15 Minutes
- Apply a topical vasoconstrictor spray such as oxymetazoline (Afrin) or phenylephrine - spray 2 times into the bleeding nostril after clearing any blood clots 1, 2
- Resume firm compression for another 5-10 minutes after applying the vasoconstrictor 2
- This combination stops bleeding in 65-75% of cases 1, 2
After Bleeding Stops
- Apply petroleum jelly or other moisturizing agents to the inside of your nose to prevent recurrence 1, 2
- Use saline nasal spray regularly to keep the nasal mucosa moist 1, 2
- Avoid picking, rubbing, or blowing your nose vigorously for at least 7-10 days to allow healing 2
Warning Signs Requiring Emergency Evaluation
- Bleeding continues for more than 30 minutes despite proper compression 1
- You feel dizzy, lightheaded, or experience palpitations suggesting significant blood loss 1
- Visible deformity of the nose suggesting possible nasal fracture requiring imaging 3
- Severe facial pain, visual changes, or clear fluid draining from the nose suggesting more serious injury 3
What NOT to Do
- Do not tilt your head backward - this causes blood to flow down your throat 1, 2
- Do not apply ice directly to your nose - while commonly recommended, evidence shows ice does not significantly improve bleeding control and may actually impair coagulation 4
- Do not stop compression early to check if bleeding has stopped - this prevents proper clot formation 1, 2
When to See a Doctor Within 24-48 Hours
- If you develop persistent nasal obstruction, ongoing pain, or visible deformity after the bleeding stops, as these may indicate a nasal fracture requiring evaluation 3
- If you experience recurrent bleeding episodes despite following preventive measures 1
- For assessment of any structural damage from the trauma, particularly if there is concern for septal deviation or fracture 3