Dr. Dean

What Is The Cause Of A Gushing Nosebleed?

Posting Date: 11/14/2000

Deanna: My husband had a nosebleed that was a sudden gush of a lot of blood. He was dozing on his stomach and wiped at what he thought was drool. It turned out to be blood. It had soaked through the comforter, the blankets and the mattress.

This happened about three weeks ago. He has never had a nosebleed before.

Dr. Dean: The most common site for epistaxis -- a nosebleed -- is a spot known as Kiesselbach's plexus. It's in the front of the nose, and it's where all the little blood vessels end like a stretch of railroad tracks that suddenly stop.

So it is a place that gets dry and scabby -- especially in winter -- because it's not well oxygenated. Pressure on the nose, your husband lying face down for instance, can disturb that little dry spot and cause the accumulated blood vessels to bleed.

The way to stop a nosebleed and to test its source is simply to pinch the front of the nose where Kiesselbach's plexus is and hold it for five minutes. If that doesn't work, try one more five-minute stint. A failure the second time implies that the bleeding might be coming from somewhere deeper, so at that point you should go to the emergency room.

If he had been gushing blood from a major vessel like an artery, it wouldn't have stopped. And certainly if it becomes repetitive, he should see his doctor because nosebleeds can be the first sign of a serious blood disorder like leukemia.

I doubt very much, though, that you have anything to worry about. Nosebleeds are almost always benign.