Believe it or not, I got my first nose bleed this weekend when I was home. 18 years old and I didn’t know what to do when blood started dripping from my nose. My mother and I got into an argument while trying to resolve the issue when we couldn’t agree on which way to tilt my head. My natural instinct was to tilt my head forward so that the blood didn’t get on me, but she wanted me to pinch my nose and tilt my head back. So which is it? Forward or backward?
I, first, want to look at how and why we get nose bleeds because it often times makes me 
wonder why our noses can just start to bleed. Well, it turns out that there are two types of
nosebleeds, anterior (front of nose) and posterior (back of nose). According to WebMd, anterior nose bleeds are more common and less dangerous. The blood in anterior bleeds comes from blood vessels which are easier to stop the bleeding versus the bleeding from an artery in the back of the nose, which comes with posterior nose bleeds. Posterior nosebleeds are not common but happen the most in elderly people and require medical help to stop the bleeding.
So what causes the nose bleeds?
Nose bleeds are caused by numerous variables. According to this cite, nosebleeds can be caused by nose trauma, exposure to dry air, nasal and sinus infections, vigorous nose blowing, nasal surgery, and even cocaine use. Nose trauma would be any outside force colliding with the nose. For example, sports injuries, accidental bumps, piercings, and even picking your nose. Vigorous nose blowing goes hand in hand with having a sinus infection and dry air. If your nose is dry or you are constantly blowing your nose, it is more likely for you to get a bloody nose that way because you can pop blood vessels by constantly and viciously blowing your nose.
Now that we know the science behind nose bleeds, we can look into which way you are supposed to tilt your head and why.
After looking at many sites, they all seemed to give me the same answer. According to Dr. Diane Heatley, you are supposed to tilt your head forward when you have a nose bleed. This is to prevent the blood from going down your throat and putting you at risk for choking. While your head is tilted forward she advises that you add pressure to the nose to induce normal blood clotting to occur. When it comes to adding ice into the equation she says “A cold cloth or small ice pack on the bridge of the nose will also slow blood flow by constricting blood vessels.”
So there you have it, you are supposed to tilt your head forward and not back.
In addition to my other reply – I believe that using ice at the brim and pinching the brim of your nose is perfectly safe to do. It will initially help the stop the blood flow. A study at Harvard confirmed this information. http://www.health.harvard.edu/blog/stopping-nosebleeds-a-pinch-will-usually-do-the-trick-201310186769
It is funny you posed about this because my mom and I had a conversation regarding the nose bleed positions not too long ago! As a child it was always apparent to us that we should tilt out heads back. This was so less blood would escape from the nose and keep everything clean. More recently – we realized that leaning your head back was unsafe. This was due to what you stated. It can induce choking or form blood clots. Below is a link of different ways nosebleed occur and how to treat/prevent them! Hopefully you can check this out and gain even more insight.
http://www.ihtc.org/wp-content/uploads/2013/07/4-Pharm-Nosebleed-Treatment.pdf
I suffer very severely from nose bleeds as the weather and air changes from season to season, most commonly from fall to winter and winter to spring. One problem I have found with leaning forward during an anterior nose bleed is the scabbing. Essentially when you get an anterior nose bleed it is a small cut inside the nostril. To stop the bleeding, the body naturally wants to scab over inside the nose just like it would on the arm or any other part of the body. The problem with this is they have never healed for me, so I have constant nose bleeds pretty much half of the year. I have found that, for some reason, when I tilt my head back upon getting a nose bleed, my nose generally does not scab over as easily and heals the cuts a bit faster. I’ll take the risk of choking for a couple seconds on blood running down my throat in order to get rid of a few cuts in my nose that never heal.