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Nosebleed

Definition

  • Bleeding from 1 or both nostrils
  • No known injury

Causes

  • Nosebleeds are common because of the rich blood supply of the nose. Common causes include:
  • Dryness of the nasal lining (e.g., from forced air furnace in winter)
  • Antihistamines (Reason: they also dry the nose)
  • Vigorous nose blowing
  • Ibuprofen and aspirin (Reason: increase bleeding tendency)
  • Suctioning the nose can sometimes cause bleeding
  • Picking or rubbing the nose
  • Predisposing factors that make the nasal lining more fragile: nasal allergies, colds and sinus infections

Disclaimer: This information is not intended to 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. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

When To Call

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

  • Fainted or too weak to stand

Call Your Doctor Now (night or day) If

  • You think your child has a serious injury
  • Bleeding does not stop after 10 minutes of direct pressure applied correctly and tried twice
  • New skin bruises or bleeding gums not caused by an injury are also present
  • Large amount of blood has been lost
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Age under 1 year old
  • New-onset nosebleeds are occurring frequently
  • Hard-to-stop nosebleeds are a recurrent chronic problem
  • Easy bleeding present in other family members

Parent Care at Home If

  • Mild nosebleed and you don't think your child needs to be seen

Disclaimer: This information is not intended to 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. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

Care Advice

  1. Reassurance:
    • Nosebleeds are common.
    • You should be able to stop the bleeding if you use the correct technique.
  2. Apply Pressure:
    • Gently squeeze the soft parts of the lower nose against the center wall for 10 minutes. This should apply continuous pressure to 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.
  3. Insert Gauze:
    • If pressure alone fails, insert a gauze wet with a few decongestant nose drops (e.g., nonprescription Afrin). (Reason: The gauze helps to apply pressure and nose drops shrink the blood vessels).
    • If not available or less than one year old, use petroleum jelly applied to gauze.
    • Repeat the process of gently squeezing the lower soft parts of the nose for 10 minutes.
  4. Prevent Recurrent Nosebleeds:
    • If the air in your home is dry, use a humidifier to keep the nose from drying out.
    • Apply petroleum jelly to the center wall of the nose 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.
    • Avoid aspirin and ibuprofen (Reason: increase bleeding tendency).
  5. Expected Course: Over 99% of nosebleeds will stop following 10 minutes of direct pressure if you press on the right spot. After swallowing blood from a nosebleed, your child may vomit a little blood or pass a dark stool tomorrow.
  6. Call Your Doctor If:
    • Unable to stop bleeding with 20 minutes of direct pressure
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms. 

To find a pediatrician, click here.

Disclaimer: This information is not intended to 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. For more information, click here 

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

Photos

First Aid - Nosebleed

  • Sit up and lean forward. This will keep the blood from running down the back of the throat.
  • Apply Pressure. Gently squeeze the lower soft parts of the nose against the center wall for 15 minutes. (Goal: apply continuous pressure to the bleeding point.) Use your thumb and your index finger in a pinching manner. If the bleeding continues, move your point of pressure and repeat again for another 15 minutes.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

Disclaimer: This information is not intended to 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. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

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