Bleeding Emergency Checker

This tool helps you determine if your bleeding symptoms require emergency care. Based on guidelines from the NHS and American College of Surgeons, select symptoms you're experiencing to get clear guidance on whether you need to go to the ER immediately.

Select symptoms you're experiencing:

Taking a blood thinner can feel like walking a tightrope. You’re on it to prevent a stroke or a clot in your lungs, but every little cut, nosebleed, or bruise makes you wonder: is this normal or is this dangerous? You’re not alone. Millions of people in the UK and US take these medications daily, and most never have a serious problem. But when bleeding doesn’t stop - or when it happens inside your body - it can turn life-threatening in minutes. Knowing the difference between a nuisance bleed and an emergency could save your life.

What Are Blood Thinners, Really?

Blood thinners - or anticoagulants - aren’t actually thinning your blood. They’re slowing down the clotting process. Common ones include warfarin (Coumadin), apixaban (Eliquis), dabigatran (Pradaxa), and rivaroxaban (Xarelto). These drugs are prescribed for conditions like atrial fibrillation, deep vein thrombosis, or after a pulmonary embolism. Without them, clots can form and travel to your brain, heart, or lungs - causing a stroke, heart attack, or death.

But because they stop clots from forming, they also make it harder for your body to stop bleeding. That’s the trade-off. About 3% of people on these meds have a major bleeding event each year. For most, it’s manageable. For some, it’s an emergency.

What Counts as a Medical Emergency?

If you’re on a blood thinner, not every bleed needs an ER visit. But some signs mean you need help right now.

  • Vomiting blood - whether it’s bright red or looks like coffee grounds.
  • Coughing up blood - even a small amount, especially if it’s fresh red.
  • Blood in your urine - pink, red, or brown urine isn’t normal.
  • Black, tarry stools - this means bleeding in your stomach or intestines.
  • A nosebleed that won’t stop after 30 minutes - even if you’re pinching hard.
  • Sudden, severe headache or confusion after a bump to the head - even if you feel fine at first.
  • Unexplained swelling, pain, or tightness in your abdomen, back, or thigh - could be internal bleeding.
  • Dizziness, fainting, or feeling like you’re going to pass out - especially if you’ve had a recent cut or injury.
  • Extreme fatigue or shortness of breath - like you can’t catch your breath walking up stairs.

These aren’t guesses. These are the red flags backed by the NHS, American College of Surgeons, and the Journal of Thrombosis and Haemostasis. Internal bleeding - like in your brain, gut, or behind your abdomen - doesn’t always hurt right away. It can sneak up on you. By the time you feel weak or dizzy, you’ve already lost a dangerous amount of blood.

What’s Just a Nuisance Bleed?

Most bleeding episodes on blood thinners aren’t emergencies. In fact, over half of ER visits by people on anticoagulants are for things that could’ve been handled at home.

  • Minor cuts that take 5-10 minutes longer than usual to stop bleeding.
  • Small nosebleeds that stop after 10-15 minutes of firm pressure.
  • Bleeding gums when brushing your teeth.
  • Small bruises that show up without a clear reason.

These are common. About 52% of ER visits by blood thinner users are for these kinds of bleeds, according to Stop the Clot’s 2023 survey. And yet, 68% of people who stopped their medication after a minor bleed ended up with a dangerous clot within 30 days.

Don’t panic. Don’t stop your pill. But don’t ignore it either. Call your doctor or pharmacist. Ask: “Is this normal? Should I do anything differently?” Many clinics now offer phone triage for exactly this reason.

Emergency room paramedic rushing patient with CT scan showing brain bleed

How to Handle Minor Bleeding at Home

If you’re sure it’s minor, here’s what works:

  1. Apply firm, continuous pressure - not light taps, not checking every few seconds. Press hard enough that it hurts a little. Use a clean cloth or gauze. Keep pressure on for at least 10 minutes. No peeking.
  2. Elevate the area - raise a cut arm or leg above your heart if you can.
  3. For nosebleeds - pinch the soft part of your nose (not the bridge) for 10-15 minutes. Sit upright, lean slightly forward. Don’t tilt your head back - you might swallow blood and gag.
  4. Don’t use hydrogen peroxide or alcohol - they irritate tissue and slow healing.
  5. Use ice - wrapped in a towel - on bruises or swelling to reduce blood flow.

Most minor cuts stop within 5-7 minutes with proper pressure. In someone not on blood thinners, it’s usually 2-3 minutes. That extra time isn’t a failure - it’s expected.

Head Injuries Are a Special Risk

Even a small bump on the head can be dangerous if you’re on a blood thinner. Internal bleeding in the brain doesn’t always show up right away. You might feel fine for hours - even a full day - then suddenly get a terrible headache, vomit, or become confused.

Any head injury - even a fall on the sidewalk or hitting your head on a cabinet - should be evaluated by a doctor. Don’t wait for symptoms. If you’re on warfarin, apixaban, or any anticoagulant, go to the ER after a head injury. CT scans are fast and can catch bleeding before it’s life-threatening.

Don’t Stop Your Medication

This is the biggest mistake people make. When they have a nosebleed or bruise, they think, “I’ll skip my pill for a few days until this calms down.”

That’s dangerous. Your risk of stroke or clot jumps within 24-48 hours of stopping. One study showed that stopping your blood thinner for a minor bleed increases your risk of a clot by 300% in the first week. And 68% of those who stopped had a clot within 30 days.

Your doctor can adjust your dose, give you reversal agents, or monitor you closely. But you don’t get to decide when to quit. Always talk to them first.

Person at kitchen table reflecting on blood thinner risks with clot overlay

What’s New in Bleeding Treatment?

There’s good news. Five years ago, if you had a major bleed on a newer blood thinner like rivaroxaban, doctors had to wait for the drug to wear off - which could take hours. Now, there are reversal agents.

Andexanet alfa (Andexxa) can reverse apixaban and rivaroxaban in under an hour. It’s not available everywhere yet, but major hospitals in the UK and US are starting to stock it. And by 2026, a new universal reversal agent called ciraparantag could be approved - one drug that works for all types of anticoagulants.

Emergency departments are also getting better at testing blood clotting speed on the spot. Within minutes of your arrival, they can know if you need reversal, transfusion, or just observation.

When in Doubt, Call for Help

If you’re unsure - call your doctor, call 111, or go to the nearest emergency department. Better safe than sorry. Thousands of people have survived major bleeds because they didn’t wait.

And if you’ve ever been to the ER for a nosebleed that turned out to be nothing - you’re not alone. But don’t let that make you complacent. Next time, ask: “Is this the same? Or is this different?” If it’s worse, faster, or you feel unwell - don’t wait.

Living on a blood thinner isn’t about avoiding all risk. It’s about knowing when to act - and when to trust your body’s warning signs.

How long should I press on a cut before going to the ER?

Apply firm, continuous pressure for at least 10-15 minutes. If the bleeding hasn’t slowed or stopped by then, go to the emergency department. Don’t check early - lifting your hand to see breaks the pressure. It should hurt a little. That’s how you know you’re pressing hard enough.

Can I still take aspirin or ibuprofen while on a blood thinner?

Avoid ibuprofen, naproxen, and other NSAIDs unless your doctor says it’s safe. They can increase bleeding risk. Aspirin is also a blood thinner - taking it with your anticoagulant can double your bleeding risk. Always check with your prescriber before adding any painkiller, even over-the-counter ones.

Is it safe to use a razor or electric shaver?

Electric shavers are safer than razors. Blades can cause small nicks that bleed longer than expected. If you must use a razor, go slowly, use shaving cream, and keep your skin taut. Have a clean cloth ready. If you nick yourself, apply pressure for 10 minutes. If it doesn’t stop, call your doctor.

What should I do if I fall and don’t feel hurt right away?

Even if you feel fine, go to the ER for evaluation - especially if you hit your head, back, or abdomen. Internal bleeding from trauma can take hours to show symptoms. A CT scan can catch bleeding before it becomes life-threatening. Waiting can cost you your life.

Can I drink alcohol while on blood thinners?

Moderation is key. One drink a day may be okay for some people, but alcohol can interfere with how your liver processes warfarin and increase bleeding risk. It can also make you unsteady, raising your chance of falls. Always talk to your doctor about your alcohol use - they’ll tailor advice based on your medication and health.

How do I know if I’m bleeding internally?

Internal bleeding doesn’t always show on the skin. Watch for sudden dizziness, fainting, shortness of breath, extreme fatigue, unexplained swelling or pain in your belly or back, or dark, tarry stools. If you feel worse than usual - even without a clear injury - get checked. These are signs your body is losing blood internally.

Should I wear a medical alert bracelet?

Yes. In an emergency, paramedics and ER staff need to know you’re on a blood thinner - especially if you’re unconscious. A simple bracelet that says “On Anticoagulant” can save your life. It helps them act faster, avoid harmful drugs, and start reversal treatment sooner.

What Comes Next?

If you’ve had a bleeding scare, schedule a follow-up with your anticoagulation clinic or GP. Ask about your INR (if on warfarin) or whether your DOAC dose needs adjusting. Ask if you qualify for a bleeding management plan - many clinics now offer personalized advice, phone support, and even apps to track symptoms.

And if you’ve ever stopped your medication because of a nosebleed - don’t beat yourself up. But do learn from it. You’re not alone. The goal isn’t to avoid all bleeding. It’s to manage it wisely - so you stay protected from clots without putting yourself at risk from bleeding.