It is just so alarming!

Out of the blue, blood starts pouring out of somebody’s nose. A Kleenex turns crimson. A paper towel gets soaked. Ten minutes later, panic takes over. It’s still bleeding. It’s a mess! It’s a catastrophe!

It’s normal.

The good news about nosebleeds is that they’re almost always nothing but a nuisance. Dr. Richard Dudrak, medical director of Urgent Care by Lifetime Health, says the odds of real danger are low. “Probably far less than 1 percent,” he says.

“The vast majority happen in the front part of the nose. In the front part, they’re very easy to control. It’s in the back portion of the nose that it’s higher risk of being an artery.” But not to worry: “Those can usually be taken care of with medical intervention.”

Nosebleeds occur more in winter because the air is dry. Older people tend to get them because their noses are drier and suffer more from lack of humidity. Kids tend to get them because they hurt themselves, and because they stick things, including fingers, in their noses. Colds can bring on nosebleeds, because symptoms irritate the nostrils.

Use of blood thinners could present a nosebleed problem. “It increases the likelihood of persistent bleeds,” Dudrak says. Those odds, though, need not mean worry. “Most people who are on blood thinners and suffer nosebleeds do not get into trouble,” Dudrak says. “Because most of the nosebleeds are in the anterior (front) part of the nose, where pressure can stop it.”

The inside of the nose has a lot of blood vessels, hence the dramatic bleeding. But it’s not as bad as it looks.

“The likelihood of having severe blood loss is actually very tiny,” Dudrak says.

In contrast, the likelihood of having a nosebleed is large. Dudrak says most people just treat them at home.

“We wind up seeing only a handful a year,” Dudrak says. “But it’s common, seeing someone, to hear, ‘I had a nosebleed in the course of an illness.’ ”

Know your nosebleeds

Bonny Klein, the nurse at Christ the King School in Snyder, reckons she treats 10 nosebleeds a week.

Once, at a different school, she had an extreme case.

“We had this girl, I don’t think she had any underlying health issues, but she would hemorrhage out of her nose, for an hour,” Klein says. “It was frequent, horrible. She’d have to go home, change her clothes. It was awful. Awful.”

Most cases she encounters are routine.

“My first question is usually injuries – if they fell, bumped their face,” she says. “We see a lot of nosebleeds this time of year from dry heat in homes, kids having viruses or colds. Then they take medications – cough medicines, antihistamines – that dry them out even more.

“We put pressure on it. If it’s really bad, we put an ice pack over their nose,” she says. “An old wives’ remedy is to put pressure on the nose and put the head back. That you should never do. Blood could run down the throat into the stomach, and they can get sick to their stomach. I always tell kids to squeeze their nose as if something smells bad. Don’t stuff it. A lot of kids want to stuff things in their nose. They shouldn’t do that.”

Dudrak also advocates holding your nose.

“When you’re acutely suffering a nosebleed, the best thing to do is to pinch the bridge of the nose, and hold it without stopping for seven minutes,” he says. “If you apply direct pressure that way, you will cure almost all nosebleeds. It’s also helpful to tell them not to panic.” He suggests slow, deep breaths through the mouth.

Keys to a nosebleed

The best remedy for nosebleeds, of course, is prevention.

“One of the most important things is to keep the air humidified,” Dudrak says. “Running a vaporizer, especially if you don’t have one built into your heating system, is very helpful in the dry winter months. If you feel you already have a dry nose, using a nasal saline spray is a good idea.”

But, he cautions, “With saline spray you have to be careful. You have to get one you mix yourself with distilled or boiled water, or a premixed one that doesn’t come in a plastic bottle.” The plastic, he says, has a preservative shown to be a nasal irritant.

Klein likes Ayr Gel – not Vaseline, because Vaseline has petroleum. “Use a Q-Tip, go around the inside of the nostril. It moisturizes.”

What’s new with nosebleeds? “They have a device called a Rhino Rocket,” says Dudrak. “It’s a clinic-based balloon that you inflate.” The balloon, inflated inside your nose, stops the bleeding.

Nosebleed treatment, however, has probably not changed much since the Middle Ages.

The People’s Pharmacy, the syndicated column that runs in The Buffalo News, has a bizarre remedy, said to go back centuries. Place a set of keys on the back of the nosebleeder’s neck, and the bleeding stops. Many of their readers swear by it.

Neither Klein nor Dudrak had heard of that fix. Neither, though, sniffs at it.

Dudrak says the shock of the cold keys might stop the bleeding. Klein, too, is intrigued.

“There must be some major blood vessel back there, or something,” she says.