When to Worry About a Nosebleed

When to worry about nosebleeds?

Nosebleeds are a benign condition that is usually self-limited and needs no medical care, but in some cases, it can be a sign of an underlying disease that requires medical care. These signs should alert you that your bleeding nose isn’t simply a bleeding nose:

  • Your bleeding doesn’t stop: In minor trauma, bleeding should stop within a few minutes, if it doesn’t or if you feel like the blood is moving down your throat in excessive amounts, this may be a danger sign and medical care is needed.
  • If you feel like your nose is broken: If you sustained a severe trauma and feel like your nose is misaligned, your nasal bone may be broken, and you should visit an ER.
  • If there are other sites of bleeding: If your nasal bleeds occur with bleeding per gums, easy bruising, bloody urine or vaginal secretions, this could point towards a coagulation problem and investigations need to be done.
  • If you are have chronic hypertension: Despite the popular misconception that severe hypertension presents with headache, hypertension is actually almost always asymptomatic and a bleeding nose in a chronic hypertensive especially if the patient is above 60 is an enough reason to visit a hospital.
  • You are on an anticoagulant medication: Some medications like warfarin used in patients who underwent heart replacement surgery or those with recurrent deep venous thrombosis alter the blood’s ability to coagulate, and therefore any excessive nosebleed in such patients may necessitate a visit to the ER.
  • You cough blood or feel choked: If bleeding occurs in the posterior part of the nasal septum, it tends to be severe and to move down the throat. This can cause severe choking and aspiration which is life-threatening and emergency control of bleeding is needed.