Nosebleeds

Sit still and lean slightly forward. Do not lie down or tip your head back, because blood running down the throat will make you feel sick. Breathe through your mouth and spit out any blood rather than swallowing it.

Pinch the soft part of the nose, below the bony bridge, between finger and thumb. Keep pinching for a full 10 to 15 minutes by the clock. Do not let go early to check, because that undoes the clot. A decongestant nasal spray into the bleeding nostril before you start makes the pressure far more likely to work, and an ice pack on the bridge of the nose or the back of the neck may help.

For the next 24 to 48 hours avoid nose blowing, picking, heavy lifting, straining, hot showers and hot drinks. Any of these can start it again. Sneeze with your mouth open. Do not stop prescribed blood thinners without medical advice.

The lining bleeds when it dries and cracks, so the aim is to keep it moist. A pea-sized amount of ointment wiped just inside the front of each nostril twice daily, and a saline spray several times a day, do most of the work. Keep fingernails short, avoid blowing your nose, rinse with saline instead to clear congestion, and treat hay fever and colds so the nose is not congested and fragile. Aim nasal sprays away from the septum. A humidifier helps if you sleep in air-conditioning.

If nosebleeds keep coming back, I can examine the nose, and if a fragile vessel is found I can seal it with cautery. That is usually done in the clinic under local anaesthetic.