EPISTAXIS PROTOCOL

Version May 20, 2022

Essential rules

Never tilt the head backward — risk of swallowing blood
Swallowed blood is indigestible → vomiting
High risk of vomiting blood — remain vigilant
Normal coagulation: about 10 minutes

🚫 Head backward — ForbiddenThe victim will swallow a large amount of blood which they will then vomit, because blood is indigestible. Always keep the head tilted forward.

⚠ Vomiting bloodThere is a high risk of vomiting blood following a nosebleed. Stay alert and provide a container if necessary.

🦺 Traumatic originIf the nosebleed is of traumatic origin, perform cervical spine stabilization at all times.

⏱ Coagulation — 10 minutesNormal coagulation takes about 10 minutes. Maintain nasal compression for at least 10 minutes without releasing.

📊 Continuous reassessmentReassess vital signs (ABC) frequently during and after the episode.

PROTOCOL — EPISTAXIS (NOSEBLEED)

😌 Reassure the victim
Explain the steps and keep them calm

👃 Tilt the victim forward
Firmly pinch the nostrils

⏱Maintain for a minimum of 10 minutes

🚫 Ask the victim not to swallow the blood
→ Spit it into a container

🛌 Place the victim at complete rest

⏱At least 1 hour after the bleeding stops

📊 Frequently reassess the vital signs (ABC)
Monitor for any vomiting of blood

Has the bleeding stopped?

✓ YES — Stopped

Maintain rest
for at least 1 hour
Monitor for any recurrence

✕ NO — Still active

⏱ after 20 minutes

📞 Seek care at a hospital
by calling 911