Annual Probability of Nosebleed Requiring ER Visit

Nosebleeds (epistaxis) are extremely common, with about 60% of people experiencing one at some point during their lifetime and about 10% experiencing one in any given year. However, most are minor and self-resolving. Approximately 600,000 Americans (about 0.2% of the population) seek emergency care for nosebleeds each year, and about 1 in 200 of those (about 3,000) require hospitalization.

Most nosebleeds (about 90%) are anterior, originating from the nasal septum's rich blood vessel network (Kiesselbach's plexus). These are typically mild and stop with simple pressure. Posterior nosebleeds (about 10%) originate deeper in the nasal cavity, tend to be more severe, and are more common in older adults and those on blood thinners.

Risk factors include dry air (the most common trigger), nose picking, upper respiratory infections, allergies, blood-thinning medications (aspirin, warfarin, DOACs), hypertension, nasal trauma, and deviated septum. First aid involves leaning forward slightly, pinching the soft part of the nose for 10-15 minutes continuously, and avoiding lying back (which causes blood to run down the throat). Medical attention should be sought if bleeding persists beyond 20 minutes, is very heavy, follows a head injury, or occurs in someone taking blood thinners.