(EPISTAXIS)

Most nosebleeds are caused by nasal congestion or chronic irritation. They occur mainly at night or early in the morning (increased blood flow to nose). They are often related to exercise, allergy, and nose picking or sinus infection.

Important Questions:

  • Are there any sinus or allergy symptoms? This may include congestion, coughing, hoarseness, creamy yellow discharge, or clear drainage.
  • Are there any other signs of easy bruising or excessive bleeding with minor cuts, surgical procedures, or menstrual periods?
  • Is there any family history of easy bruising or excessive bleeding with minor cuts, surgical procedure, or menstrual periods?
  • Is there any family history of easy bruisability or prolonged bleeding?
  • Is the environment in your house excessively dry from heat or air conditioning?
  • Is your house excessively dusty or musty-smelling?
  • Do you use allergy or steroid nasal spray?

To stop a nosebleed, have the child sit upright. Pinch the nose tightly and apply pressure both toward the center of the bone and back toward the bridge. Hold firmly for about 10 minutes. Apply a cold pack to the nasal spray?

To Minimize the Frequency of nosebleeds:

  • Elevate the head of the bed at night.
  • Apply a small amount of Vaseline or antibiotic ointment in a thin film to the inner part of the nose (septum).
  • Use saline mist or gel (Ayr, Na-Sal, Ocean Spray, etc) to moisturize nostrils as often as needed.
  • Turn OFF a cool mist humidifier; adjust heat or air conditioning to minimize mold.
  • Attempt to allergy-proof your child’s bedroom, including dusting, vacuuming, turning off ceiling fans, and employing a HEPA room air purifier.
  • Use saline before using the steroid nasal spray. Steroid sprays should point away from the septum (center of nose).
  • OTC allergy medications and BTC Sudafed are helpful to minimize swelling.

Sneezing, nose blowing, or crying may dislodge the clot, causing the nose to bleed again. It is not unusual for a child to throw up or have a black bowel movement when the blood is swallowed.

Relations to Sinus Infections:

Sinus infections can be prevented with the suggestions given above. Antibiotics may be needed if the congestions persists  for greater than 7-10 days can be avoided with good nose blowing and saline usage.