Nosebleeds
If you have a bleeding disorder, you may be prone to nosebleeds. Dry air in cold winter months and seasonal changes that produce allergy symptoms, such as sneezing, can aggravate nasal membranes. There are many over-the-counter and prescription allergy treatments that can ease allergy symptoms. To reduce the likelihood of a nosebleed, keep your nose moistened with an over the counter normal saline solution or gel such as Ayr Gel®.
If you get a nosebleed, try these tips to stop your nosebleed.
• Tilt your head forward so the blood will not run down your throat. Tilting forward also helps you tell when the bleeding has stopped.
• Press the sides of the nose together firmly. You may have to hold pressure for 10-20 minutes for the bleeding to stop.
• Nose clips might be helpful to keep pressure applied for 10-20 minutes.
• If holding your nose does not work, try putting an ice pack over the bridge of your nose. The cold temperature will help shrink the blood vessels.
• The use of EACA (Amicar) or tranexamic acid may be helpful. The intranasal (nose spray) form of Amicar or Tranexamic acid are particularly helpful for nosebleeds and can be administered as 1 spray per nostril every 4-6 hours as needed. The administration of different forms of Amicar or tranexamic acid at the same time should be avoided.
People with hemophilia usually do not need to use factor concentrate for nosebleeds for the primary management. You should contact your doctor or treatment center for any of these reasons:
• The nosebleed lasts longer than usual (>15-30 minutes) or is a very bad one.
• You think you may need to infuse factor. Go ahead and infuse the factor, but call the doctor too.
• You have nosebleeds often. If you lose a lot of blood this way, you may need to be checked for anemia (low blood).
Nose clips and Nose Buds® (small ice packs for the bridge of the nose) are available from your pharmacy team and outreach nurse.
Source: The Hemophilia, von Willebrand Disease, & Platelet Disorders Handbook, https://www.hog.org/handbook/article/3/33/nosebleeds
Reviewed and revised by Drs. Batsuli, Kempton, and Sidonio - March 4, 2018.