Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A minor nosebleed that has stopped may require no treatment at all. Frequently, the body will
form a clot at the site of the bleeding that stops any further bleeding.
If the source of the bleeding is from a blood vessel that is easily seen, a
health care practitioner may cauterize it (seal the blood vessel) with a chemical called silver nitrate after applying a local topical anesthetic inside the nose. Chemical cauterization is most effective when the visible bleeding originates from the very front part of the nose.
In more complicated cases, a nasal packing may be required to stop the bleeding. Nasal packings apply direct pressure inside the nostril to promote clotting and stop the bleeding. Many different types of nasal packings are available, including petroleum (Vaseline) gauze, balloon nasal packs, and synthetic sponge packs that expand when moistened. The decision as to which one to use is made by the
health care practitioner.
Most people who receive an anterior nasal packing go home with it in place. Because these packings block the drainage pathways of the sinuses, antibiotics may be started to prevent a sinus infection. The packing is usually left in place for 48
to 72 hours.
A posterior nosebleed that does not stop bleeding on its own requires
admission to the hospital, as these types of nosebleeds can be very serious. In
order to control the bleeding, a posterior nasal packing will be inserted by
your health care practitioner. Different types of packings are available, though a balloon nasal pack is most commonly used.
Unlike anterior nasal packings, posterior nasal packings are much more uncomfortable and frequently require sedatives and pain medications. Furthermore, potential complications such as infection and blockage of the breathing passages may be encountered with posterior nasal packings. Consequently, admission to the hospital, close monitoring
and consultation with an otolaryngologist are required.
Posterior packings are usually left in place for 48 to 72 hours. If this does not control the bleeding, arterial embolization or certain surgical procedures may be required.