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Do I tilt my head forwards or backwards during a nosebleed?

Nosebleeds can affect anyone from childhood through adulthood. But what does science say about how to treat them?

In Netflix’s Stranger Things, Eleven develops a nosebleed whenever she harnesses her telekinetic powers. From crumpling a coke can to committing murder — the more exertion her psychokinesis requires, the more likely we will see her nose bleed. For us regular folk, nosebleeds are more likely the cause of trauma, dryness, or allergies. Alternatively, anatomical reasons like a deviated septum or vascular malformations may leave you with a bloody nose more often than others.

Where is that blood coming from? There are five arteries in the head that terminate in the nasal septum — the wall that separates the left and right sides of the nose. This collection of arteries joins together at what’s called the Kiesselbach’s plexus, which is responsible for warming up the air that enters the nose by transferring heat from the blood. This forms a large vascular network that is close to the surface of the skin, making it susceptible to bleeding if you get smacked in the face, blow your nose one too many times, or simply if your skin cracks from dry air. If one of those blood vessels ruptures, you end up with a nosebleed (also called epistaxis). While over 90% of the time nosebleeds occur in the Kiesselbach’s plexus, sometimes they occur more posteriorly. These are far less common and will likely drain down the throat.

So, to answer the debated question — when treating these pesky nosebleeds do I tilt my head forwards or backwards? First aid standards have changed throughout the years, making it difficult to keep up with the right practice. Tilting your head backwards is common misconception. Currently, Red Cross standards and most clinicians inform us to sit neutral, tilt head slightly forward, pinch the bridge of the nose, and wait for 10-15 minutes.

The idea is that you want the blood to clot where the artery burst, giving the body enough time to repair the damage. Imagine there’s a hole in your garden hose, and you squeeze it closed with your hand until someone can come by with a patch kit. By holding the bridge of the nose, you slow blood flow and help encourage clotting. If your head was tilted backwards, the blood would flow away from the damage site, and it wouldn’t be able to clot. It’s also likely the blood will rush back down the esophagus, creating a choking hazard and potentially irritation when the blood reaches the stomach. Another treatment that has been researched is icing the bridge of the nose. By constricting the blood vessels, it also slows the flow of the blood and promotes clotting.

It would be most ideal to avoid nosebleeds altogether, if possible. So, try to stay away from excessive dryness and supernatural activity.


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