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PEDIATRICS

Nosebleeds

Nosebleeds can be scary! The good news is that most of them are not serious and can be stopped with home treatment. The majority of nosebleeds come from the front (anterior) of the nose and involve just one side of the nose. The blood can drain down to the back of your child's nose and drip down the back of their throat.

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A more serious kind of nosebleed comes from the back (posterior) of the nose. This kind of nosebleed often involves BOTH sides of the nose. Large amounts of blood can run down the back of the throat. This type of nosebleed is more common in older adults and requires medical care. You cannot stop a posterior nosebleed at home.

Causes of Nosebleeds

Injuries to the nose: 

  • Nose picking or putting things inside the nose (rolled up tissue, cotton swabs or toys) 

  • Blowing the nose too much 

  • Getting struck in the nose or hitting the nose on something 

 

Things in your child's environment: 

  • Fumes from chemicals or smoke 

  • Dry air 

  • High altitude 

Medical problems 

  • Polyps inside the nose 

  • Deviated septum (when the cartilage in the centre of the nose is shifted) 

  • Abnormal blood vessels inside the nose 

  • Colds, allergies or sinus infections 

  • Liver disease 

  • Blood clotting disorders 

 

Medicines and Drugs 

  • Blood thinners like aspirin or anti-inflammatory medications (ibuprofen, naproxen, etc.) 

  • Use of oxygen, especially by nasal prongs 

  • Nasal sprays 

Stopping a Nosebleed

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  • Have your child blow their nose gently to clear away any clots 

  • Pinch their nose shut using your thumb and forefinger (see diagram); you should be pinching the soft part of their nose, close to the tip. Do not pinch up high where the firm boney part is. If you have nasal decongestant spray at home (ex. Otrivin), spray it into the affected side of the nose before pinching. 

  • Have your child sit up straight and tilt their head forward 

  • DO NOT TILT THEIR HEAD BACK! This will cause blood to run down the back of their throat and could make them vomit (which will make the nosebleed worse). 

  • Keep their nose pinched for 5 FULL MINUTES. Set a timer to make sure. Do not stop the pressure to see if it has stopped. 5 minutes will feel like forever, but it takes this long to make the bleeding stop. 

  • After the 5 minutes is up, you can check to see if the bleeding has stopped. If it is still bleeding, continue to pinch for another 15 minutes. 

  • DO NOT LET YOUR CHILD BLOW THEIR NOSE FOR 24 HOURS. If their nose is running, dab it, but do not let them blow and do not put tissue inside the nose. 

  • Have your child rest quietly for a few hours after the nosebleed has stopped. 

When to See a Doctor

  • You think your child is having a posterior nosebleed (heavy bleeding from both sides of the nose) 

  • You cannot stop your child's nosebleed after 20 minutes of good, firm pressure 

  • Your child is getting frequent nosebleeds (4 or more times in 1 week) 

  • Your child's symptoms are getting worse or more frequent 

How to Prevent Nosebleeds

  • Discourage nose picking 

  • Moisturize your child's nose: 

    • Use a thin layer of petroleum jelly inside their nose at bedtime. You can put a small amount of jelly just inside each nostril and then have them gently inhale it to coat the inside of the nose. You can use your finger to spread it if you need to, but NO PICKING! 

    • Use a vaporizer or humidifier in your house, especially in your child's bedroom at night. This is most important during the cold and dry winter months. 

  • Do not smoke around your child and do not let others smoke around them 

  • Limit the use of decongestants and antihistamines

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