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  • Nosebleed

    Definition

    • Bleeding from 1 or both nostrils Not caused by an injury

    Causes

    Nosebleeds are common because of the rich blood supply of the nose. Common causes include:

    • Dryness of the nasal lining. In the winter, forced air heating often can dry out the nose.
    • Antihistamines (Reason: Dry out the nose)
    • Vigorous nose blowing
    • Ibuprofen and aspirin (Reason: Increases bleeding tendency)
    • Suctioning the nose can sometimes cause bleeding
    • Picking or rubbing the nose
    • Predisposing factors that make the nasal lining more fragile. Examples are nasal allergies, colds and sinus infections.

    When to Call Us for Nosebleeds

    Call 911 Now (your child may need an ambulance) If:

    • Passed out (fainted) or too weak to stand
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • Nosebleed that won’t stop after 10 minutes of squeezing the nose correctly
    • Large amount of blood has been lost
    • New skin bruises or bleeding gums not caused by an injury also present
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Age under 1 year old
    • New-onset nosebleeds happen 3 or more times in a week
    • Hard-to-stop nosebleeds are a frequent problem
    • Easy bleeding is present in other family members

    Parent Care at Home If:

    • Mild nosebleed

    Care Advice for Nosebleeds

    What You Should Know:

    • Nosebleeds are common.
    • You should be able to stop the bleeding if you use the correct technique.
    • Here is some care advice that should help.

    Squeeze the Lower Nose:

    • Gently squeeze the soft parts of the lower nose together. Gently press them against the center wall for 10 minutes. This puts constant pressure on the bleeding point.
    • Use the thumb and index finger in a pinching manner.
    • If the bleeding continues, move your point of pressure.
    • Have your child sit up and breathe through the mouth during this procedure.
    • If rebleeds, use the same technique again.

    Put Gauze Into the Nose:

    • If pressure alone fails, wet a gauze with a few decongestant nose drops. An example is Afrin. No prescription is needed. Insert the wet gauze into the side that is bleeding. Reason: The gauze helps to put pressure on the bleeding spot. The nose drops also shrink the blood vessels.
    • If you don’t have nose drops, use petroleum jelly on the gauze. Also, use petroleum jelly if your child is under 1 year of age.
    • If you don’t have gauze, use a piece of paper towel.
    • Repeat the process of gently squeezing the lower soft parts of the nose. Do this for 10 minutes.

    Prevent Recurrent Nosebleeds:

    • If the air in your home is dry, use a humidifier to keep the nose from drying out.
    • Use petroleum jelly to the center wall of the nose. Do this twice a day to promote healing.
    • For nose blowing, blow gently.
    • For nose suctioning, don’t put the suction tip very far inside. Also, move it gently.
    • Do not use aspirin and ibuprofen. Reason: Increases bleeding tendency.

    What to Expect:

    • Over 99% of nosebleeds will stop if you press on the right spot.
    • It may take 10 minutes of direct pressure.
    • After swallowing blood from a nosebleed, your child may vomit a little blood.
    • Your child may also pass a dark stool tomorrow from swallowed blood.

    Call Your Doctor If:

    • Can’t stop bleeding with 10 minutes of direct pressure done correctly
    • Your child becomes worse

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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