Myth buster: Under the nose

Published June 6, 2010

Nearly every one of us has at some point experienced or seen a nosebleed, whether in school or on television. Remember the episode of hit American comedy sitcom Friends, where at Central Park, Ross has to tell Rachel that he cannot see her anymore because his third wife, Emily demanded so and Rachel suddenly gets a nosebleed before he could get to it and she leans her head back on the couch. Also in Everybody Loves Raymond, something very similar happens.

Both actually and factually, this depicts a very common first-aid myth, that to treat a nosebleed one should tilt the head back. Another proposed solution which is also nothing more than an old wives' tale is that a cold object such as an ice cube should be placed on the neck.

The real deal is that tilting one's head back while experiencing a nosebleed causes the blood to trickle down the throat, sinuses or the airways, which can lead to gagging or choking. If enough blood passes into the stomach, its lining can get irritated and induce nausea and vomiting.

The right way to go about it is to make the person sit, stand or lie at their side, keeping the head above the heart. He or she should tilt the head forwards, pinch the fleshy tip of the nose, rather than its bony bridge and avoid coughing and swallowing. Five to 20 minutes of continuous pressure should be applied, without slacking to verify whether the flow has stopped.

After the bleeding curbs, for the next 24 hours one should try to avoid lifting heavy objects, straining in bowel movements and blowing the nose, among other things. If one is on blood thinning medication, such as Aspirin, one should stay off them or consult their physician. Should the bleeding continue after 15 or so minutes and if the patient is losing a lot of blood, he or she should be taken to the emergency room as soon as possible. A visit to the doctor upon repeated episodes is also advised.

Nosebleed or epistaxis is a common occurrence, and should not be a source of alarm. They often happen due to drying out of the nasal lining in cold weather, low humidity, flu etc. During the change of seasons, from brittle cold to burning summers, again changes take place inside the nose increasing susceptibility to nosebleeds. A q-tip or a cotton swab coated with petroleum jelly can be used to keep the nasal lining moist, and preclude at least this mechanism of the condition.

Attila the Hun, founder of the great Hunnic Empire died on his wedding night in 453 AD after he got drunk and walked into a beam, the trauma triggering a nosebleed, rendering him unconscious and causing him to choke on his own blood. Nosebleeds are seldom fatal, responsible for only four of the 2.4 million deaths in the United States in 1999, this passing anecdote perhaps being the only famous reported incident. This emphasises the importance of first-aid. A 19-year reign over an empire spanning from Germany to Russia and from Danube River to the Baltic Sea came to an end because the new bride stood frightened at his side.

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