Epistaxis: What to Do When You Have A Nosebleeds?

Created 18 June 2021 | Updated 20 June 2021 | Author: Dr Cheong 

What causes a nosebleed?

Nosebleeds are a common occurrence in young children and rarely a cause for concern. The medical name for a nosebleed is epistaxis. These are common in kids 3 to 10 years old, and most are caused by nose-picking or dry air. Dry air, whether it’s heated indoor air or a dry climate, the most common cause of nosebleeds in children is dry air that both irritates and dehydrates nasal membranes. Scratching or picking is the second most common cause of nosebleeds. Irritating the nose by scratching or picking can expose blood vessels that are prone to bleeding.

A nosebleed may also be caused by a range of factors, including: fragile blood vessels that bleed easily, perhaps in warm dry air or after exercise. an infection of the nose lining, sinuses or adenoids; an allergy that causes hay fever or coughing; and dehydration. Vitamin C deficiency can also cause frequent nosebleeds along with easy bruising, slow wound healing and dry scaly skin.

Allergies also can cause problems, as doctors may prescribe medicine (such as antihistamines or decongestants) to control an itchy, runny, or stuffy nose. The medicine can dry out nasal membranes, leading to nosebleeds.

An injury or blow to the nose can cause bleeding, but most aren't a serious problem. But if your child has a facial injury that causes a bloody nose and you can't stop the bleeding after 10 minutes or have other concerns about the injury, get medical care right away.

For bleeding not due to a sinus infection, allergies, or irritated blood vessels, a doctor may order tests to find the cause. Rarely, a bleeding disorder or abnormally formed blood vessels could be a possibility.

When to worry about a  nosebleed?

Nosebleeds are a common occurrence in young children and rarely a cause for concern. The medical name for a nosebleed is epistaxis. These are common in kids 3 to 10 years old, and most are caused by nose-picking or dry air. Dry air, whether it’s heated indoor air or a dry climate, the most common cause of nosebleeds in children is dry air that both irritates and dehydrates nasal membranes. Scratching or picking is the second most common cause of nosebleeds. Irritating the nose by scratching or picking can expose blood vessels that are prone to bleeding.

A nosebleed may also be caused by a range of factors, including: fragile blood vessels that bleed easily, perhaps in warm dry air or after exercise. an infection of the nose lining, sinuses or adenoids; an allergy that causes hay fever or coughing; and dehydration. Vitamin C deficiency can also cause frequent nosebleeds along with easy bruising, slow wound healing and dry scaly skin.

While nosebleeds are rarely serious, there might be a problem if they happen a lot. If your child gets nosebleeds more than once a week, call your doctor. Usually, frequent nosebleeds are easily treated. Sometimes tiny blood vessels inside the nose are irritated and don't heal, which happens more often in kids with ongoing allergies or who get a lot of colds. A doctor might be able to help in these cases.

Which type of nosebleed is most common?

The most common kind of nosebleed is an anterior nosebleed, which comes from the front of the nose. Capillaries, or very small blood vessels, inside the nose may break and bleed, causing this type of nosebleed.

A posterior nosebleed comes from the deepest part of the nose. Blood flows down the back of the throat even if the person is sitting or standing. Kids rarely have posterior nosebleeds. They're more common in older adults, those with high blood pressure, and people who have had nose or face injuries.

Most anterior nosebleeds are due to dry air. A dry climate or heated indoor air irritates and dries out nasal membranes. This causes crusts that may itch, then bleed when scratched or picked. Common colds also can irritate the lining of the nose, with bleeding following repeated nose-blowing. Having a cold during dry winter weather is the perfect formula for nosebleeds.

What to do during a nosebleed in children?

  • Stay calm and reassure your child.

  • Have your child sit upright in a chair or on your lap, then tilt his or her head slightly forward.

  • Do not have your child lean back. This may cause blood to flow down the back of the throat, which tastes bad and may cause gagging, coughing, or vomiting.

  • Gently pinch the soft part of the nose (just below the bony ridge) with a tissue or clean washcloth.

  • Keep pressure on the nose for about 10 minutes; if you stop too soon, bleeding may start again.

  • Have your child relax a while after a nosebleed. Discourage nose-blowing, picking, or rubbing, and any rough play.

  • Apply an ice pack to the bridge of the nose, upper lip, or back of the neck. This may help to constrict the blood vessels and reduce the bleeding.

What Not to Do during and after a nosebleed?

  • Lie flat or recline during a nosebleed. Blood could run down your throat; swallowed blood can upset your stomach and cause vomiting. And vomiting may make the bleeding worse or cause it to start again.

  • Pick or vigorously blow your nose. Both can irritate the delicate nasal passage. Blowing your nose during a nosebleed can make the bleeding worse or cause bleeding to restart after it’s stopped.

  • Bend over for a long period of time.

  • Eat warm and spicy food—which can cause blood vessels to dilate.

  • Take hot showers or baths – however, warm shower is fine. Hot water dilates the blood vessels in your nose, which may cause your nose to bleed more.

When to visit your doctor during a nosebleed?

  • The child has nosebleeds often;

  • The child has a bleeding disorder or is taking blood thinners;

  • Child may have put something in his or her nose

  • Child has heavy bleeding from minor wounds or bleeding from another place, such as the gums

  • Recently started taking new medicine

A nosebleed which requires urgent medical attention (Visit to Nearest Hospital):

  • Is heavy, or your child also has dizziness or weakness

  • Is the result of a fall or blow to the head

  • Doesn't stop after two attempts of applying pressure for 10 minutes each

  • The child also has an intense headache & fever

  • The child begins coughing up or vomiting blood

Can Nosebleeds Be Prevented?

Since most nosebleeds in kids are caused by nose-picking or irritation from hot dry air, using a few simple tips may help your kids avoid them:

 

  • Keep your child's nails short to prevent injuries from nose-picking.

  • Keep the inside of your child's nose moist with saline (saltwater) nasal spray or gel, or dab petroleum jelly or antibiotic ointment gently around the opening of the nostrils.

  • Run a cool-mist humidifier (or vaporiser) in bedrooms if the air in your home is dry. Keep the machine clean to prevent mildew buildup.

  • Make sure your kids wear protective athletic equipment during sports or other activities that could cause a nose injury.

  • Even with proper precautions, kids can still get a bloody nose occasionally. So if your child gets a nosebleed, try not to panic. They're usually harmless and are almost always easy to stop.

  • Moisturize the nose cavity after a nosebleed by using a cool mist humidifier to humidify the room at night while you sleep. Coating the inside of your nostril with petroleum jelly two times a day, especially at night.

In summary, even with proper precautions, kids can still get a bloody nose occasionally. So if your child gets a nosebleed, try not to be panic. They're usually harmless and are almost always easy to stop.