Nosebleed in a child
What should I do if my child is bleeding from the nose? We answer this question together with the pediatrician

What is a nosebleed in a child

Nosebleeds is the flow of blood from the nose, which occurs when the vascular wall is damaged. In this case, the blood has a scarlet color and flows out in drops or a stream. Profuse bleeding can be life threatening. 

There are two types of nosebleeds in children: 

  • Front. It comes from the front of the nose, usually on one side only. Often, a child’s nose bleeds due to the dry air in the room. As a result, dehydration of the mucosa occurs and cracks in the nasal membrane appear.
  • Back. It is the most dangerous, because it appears due to a violation of the integrity of large vessels. It is very difficult to stop the blood, immediately you need to call an ambulance. Occurs with increased pressure or in case of injury. This type of nosebleed in children poses a great risk to the respiratory tract, as it can cause aspiration and immediate death.

Causes of nosebleeds in children

Pediatrician Elena Pisareva highlights several causes of nosebleeds in a child: 

  • Weakness and injury to the vessels of the nasal mucosa. This is 90% of all bleeding in children. It is usually from one nostril, not intense, can stop on its own and is not dangerous.
  • Various ENT pathologies: mucosal polyps, deviated septum, anomalies of the nasal mucosa vessels, atrophic changes in the mucosa due to chronic pathology or prolonged use of vasoconstrictor drops.
  • Trauma – from banal picking in the nose to a fracture of the bones of the nose; 
  • Foreign body – small toy, bead, etc.
  • Increased blood pressure.
  • Hematological pathologies (decrease in the number of platelets, lack of coagulation factors, etc.).

Treatment of nosebleeds in children

As mentioned above, bleeding in children in most cases stops quickly and does not require medical intervention. But in 10% of cases, the situation is beyond control and it is impossible to stop the blood on its own. Doctors should be called urgently if the child has poor blood clotting (hemophilia); the child lost consciousness, fainted, the child was given drugs that help thin the blood. You should also see a doctor if you have: 

  • the threat of a large loss of blood;
  • suspicion of a skull fracture (a clear liquid flows out with the blood);
  • vomiting with blood clots (possibly damage to the esophagus, ventricle) or outflow of blood with foam. 

After the examination and studies, the doctor will prescribe the treatment of blood from the nose of the child. 

Diagnostics

Diagnosing a nosebleed in a child is not difficult. Diagnosis is carried out on the basis of complaints and a general examination using pharyngoscopy or rhinoscopy. 

– If bleeding occurs regularly, then it is necessary to be examined. Pass a clinical blood test, a coagulogram, visit a pediatrician and an ENT doctor, says Elena Pisareva.

To find out the exact cause of nosebleeds in a child, doctors, in addition to general clinical blood and urine tests, coagulograms, prescribe several additional research methods: 

  • ultrasound diagnostics of internal organs;
  • electrocardiography;
  • x-ray examination of the nasal sinuses and cranial cavity;
  • computed tomography and magnetic resonance imaging of the sinuses. 

Therapies

One of the effective methods of treatment is мmedication therapy. In this case, the pediatrician prescribes drugs that help reduce capillary fragility and permeability. In case of severe bleeding that recurs periodically, the doctor may prescribe blood products – platelet mass and fresh frozen plasma. 

Conservative methods include: 

  • conducting anterior tamponade – the method consists in introducing a gauze swab moistened with hydrogen peroxide or hemostatics into the nasal cavity.
  • conducting a posterior tamponade – a tampon is pulled with a rubber catheter from the nasal cavity to the choanae and fixed with threads that are removed from the nose and mouth.
  • in parallel with tamponade, the use of hemostatic drugs is prescribed. 

If conservative therapy has not yielded results, it is possible to use surgical methods of treatment – electrocoagulation, cryocoagulation, radio wave method, laser coagulation. 

Prevention of blood from the nose in a child at home

In order for the child not to bleed from the nose, it is important to take a number of preventive measures that will help strengthen the blood vessels: 

  • humidification of the air in the room. Parents should buy a humidifier in the nursery or in the room in which the child is most often. 
  • taking vitamin supplements. You should not choose and buy vitamins on your own, let the pediatrician prescribe the drugs.
  • the use of fresh vegetables, fruits, fish, dairy products, citrus fruits. The child should have a balanced and healthy diet; 
  • prevention of injuries of the nose and head.
  • avoid eating foods that can thin the blood: apples, tomatoes, cucumbers, strawberries, currants. This item is mainly for those children who are facing ailment.
  • taking drugs that can strengthen the child’s immunity and moisturize the nasal mucosa, this applies especially to children who are prone to allergies and frequent colds. Again, you need to consult a doctor before taking it.
  • a child, especially who often experiences nosebleeds, should avoid heavy sports, as well as serious stress. 

Popular questions and answers

Answers pediatrician Elena Pisareva.

How to provide emergency care for spontaneous blood loss from the nose?

– soothe the child;

– Plant with the head lowered forward so that the blood flows out through the nostrils; 

– Substitute a container for flowing blood (to determine the volume of blood loss); 

– Press the wings of the nose against the septum with your fingers for 10 minutes to form a blood clot, without releasing your fingers for all 10 minutes, you do not need to watch every 30 seconds whether the blood has stopped or not; 

– Apply cold to the nose area to reduce blood flow; 

If the effect is not achieved, then a sterile cotton swab should be inserted into the nasal passage, after wetting it in a 3% hydrogen peroxide solution, and again pressing the wings of the nose for 10 minutes. If the measures taken did not stop the bleeding within 20 minutes, an ambulance should be called. 

What are the erroneous actions for nosebleeds in children?

– Do not panic, because of your panic, the child begins to get nervous, his pulse quickens, pressure rises and bleeding increases;

– Do not lay down, in the prone position the blood rushes to the head, the bleeding intensifies; 

– Do not tilt your head back, so the blood will drain down the back of the throat, coughing and vomiting will occur, bleeding will increase; 

– Do not plug the nose with dry cotton, when it is removed from the nose, you will tear off the blood clot and the bleeding will resume; 

If age allows, explain to the child that you can not blow your nose, talk, swallow blood, pick your nose. 

How is a nosebleed in a child treated?

It all depends on the cause of the bleeding. Often, minor bleeding occurs just because of the dryness of the air in the room, and here a humidifier and saline solutions are needed to irrigate the nasal mucosa. If bleeding occurs frequently and profusely, this is an occasion to consult a doctor.

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