The word epistaxis, which comes from the Greek and means "dripping," is used to refer to a nosebleed. Nasal bleeding is much more common in children than in adults. One in four children will have a nosebleed at some time. Those who have a bleeding disorder may require special treatment.
There are several arteries and veins inside the nose, whose blood supply serves to heat and humidify the air before it reaches the lungs. In children, the thin membrane that lines these blood vessels is very delicate and can bleed easily.
Most nosebleeds occur in the frontal area of the nose since it contains more blood vessels.
The causes of nasal bleeding include the following:
- Allergies
- Dry air and forced-air central heating
- A foreign body in the nose
- Altitude
- Nose surgeries
- Continuous use of medications such as nasal spray
- Respiratory infections (colds)
- Sinusitis
- A trauma (blow to the nose)
What are the symptoms of nosebleed?
- Bleeding from the inside of the nose, with or without mucus
- Vomiting blood
- Black, bloody, and sticky-like-tar stools
What to do when your child has a bloody nose
- Stay calm and help the child do the same.
- Have the child be seated and ask him to lean forward slightly.
- Squeeze firmly, continuously, both sides (soft parts) of the nose for 10 minutes. The child must breathe through the mouth.
- After 10 minutes, check to see if the bleeding has stopped. If bleeding continues, squeeze the sides of the nose again for 10 more minutes.
- You can also use an ice pack or a cold compress on the bridge of the nose or sinuses.
- If the hematologist has prescribed any medication, give it to the child.
Call or see your doctor if:
- Bleeding does not stop after following all the above instructions for 20 minutes.
- It seems that the nose is fractured.
- There is a foreign body in the nose.
- The child’s stool is black, bloody, and like tar.
- The child vomits blood.
- The hematologist will probably prescribe Amicar® (epsilon aminocaproic acid), Nosebleed QR® or DDAVP (desmopressin).
- You cannot stop bleeding after 10+10 minutes of directly squeezing the nose (using the correct technique).
- The condition of the child gets worse.
What else is necessary to know?
For 24 hours after having a nosebleed, make sure the child does not:
- Blow his nose.
- Pick his nose with his finger.
- Rub his nose.
- Lift heavy things.
- Do intense physical activities (exercise).
- Hang or lie upside down.
The nose can take between 7 and 10 days to heal after the bleeding stops. During this time, the child must be very careful when blowing or rubbing his nose.
Have the child keep his nose moist with:
- A saline nasal spray.
- A humidifier or a vaporizer next to the bed.
- A little Vaseline or an antibiotic ointment (apply it inside the front of the nostrils with a cotton swab).
See a doctor if the child is very pale, weak, or dizzy.
Most nosebleeds are mild and solved with these simple measures. The most important thing is to remain calm and, above all, to reassure the child that he will get well.
What can be expected?
More than 99% of nosebleeds stop if you squeeze the nose correctly.
It may take 20 minutes of direct squeezing.
If the blood goes into the throat, the child may vomit or spit out some blood.
The child may also have dark stools the next day because of the blood that was swallowed.
By Lidia Vanessa Talavera Gutiérrez
Naturopathic General Practitioner
