
Nosebleed
Is this your child's symptom?
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Bleeding from 1 or both nostrils
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Not caused by an injury
Causes of Nosebleeds
Nosebleeds are common because of the rich blood supply of the nose. Common causes include:
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Spontaneous Nosebleed. Most nosebleeds start up without a known cause.
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Rubbing. Rubbing or picking the nose is the most common known cause. It's hard to not touch or rub the nose.
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Blowing. Blowing the nose too hard can cause a nose bleed.
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Suctioning. Suctioning the nose can sometimes cause bleeding. This can happen if the suction tip is put in too far.
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Sinus Infections. The main symptoms are lots of dry snot and a blocked nose. This leads to extra nose blowing and picking. The sinus infection is more often viral than bacterial.
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Nose Allergies. The main symptom is a very itchy nose. This leads to extra rubbing and blowing.
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Dry Air. Dryness of the nasal lining makes it more likely to bleed. In the winter, forced air heating often can dry out the nose.
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Allergy Medicines. These help the nasal symptoms, but also dry out the nose.
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Ibuprofen and Aspirin. These medicines increase the bleeding tendency. Aspirin is not used in children.
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Bleeding Disorder (Serious). This means the blood platelets or clotting factors are missing or not working right. A bleeding disorder should be suspected if the nosebleed can't be stopped. Excessive bleeding from the gums or with minor cuts is also a clue. Bleeding disorders are a rare cause of frequent nosebleeds.
WHEN TO CALL FOR NOSEBLEED
Call 911 Now
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Passed out (fainted) or too weak to stand
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You think your child has a life-threatening emergency
Call Doctor Now or Go to ER
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Nosebleed that won't stop after 10 minutes of squeezing the nose correctly
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Large amount of blood has been lost
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New skin bruises or bleeding gums not caused by an injury also present
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High-risk child (such as with low platelets or other bleeding disorder)
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You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
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You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
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Age under 1 year old
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New onset nosebleeds happen 3 or more times in a week
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Hard-to-stop nosebleeds are a frequent problem
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Easy bleeding is present in other family members
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You have other questions or concerns
Self Care at Home
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Mild nosebleed
Care Advice for Nosebleed
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What You Should Know About Nosebleeds:
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Nosebleeds are common.
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You should be able to stop the bleeding if you use the correct technique.
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Here is some care advice that should help.
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Squeeze the Lower Nose:
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Gently squeeze the soft parts of the lower nose together. Gently press them against the center wall for 10 minutes. This puts constant pressure on the bleeding point.
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Use the thumb and index finger in a pinching manner.
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If the bleeding continues, move your point of pressure.
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Have your child sit up and breathe through the mouth during this procedure.
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If rebleeds, use the same technique again.
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Put Gauze Into the Nose:
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If pressure alone fails, use a piece of gauze. Wet it with a few drops of water. Another option is to put a little petroleum jelly (such as Vaseline) on it.
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Insert the wet gauze into the side that is bleeding. Press again for 10 minutes. Reason it works: the gauze puts more pressure on the bleeding spot.
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Special nose drops: if your child has lots of nose bleeds, buy some decongestant nose drops. An example is Afrin. No prescription is needed. Put 3 drops on the gauze and press. The nose drops also shrink the blood vessels in the nose.
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Caution: don't use decongestant nose drops if your child is under 1 year of age.
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If you don't have gauze, use a piece of paper towel.
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Repeat the process of gently squeezing the lower soft parts of the nose. Do this for 10 minutes.
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Prevent Recurrent Nosebleeds:
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If the air in your home is dry, use a humidifier to keep the nose from drying out.
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Use a little petroleum jelly (such as Vaseline). Apply to the center wall of the nose. Do this twice a day to promote healing.
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For nose blowing, blow gently.
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For nose suctioning, don't put the suction tip very far inside. Also, move it gently.
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Do not use aspirin and ibuprofen. Reason: Increases bleeding tendency.
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What to Expect:
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Over 99% of nosebleeds will stop if you press on the right spot.
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It may take 10 minutes of direct pressure.
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After swallowing blood from a nosebleed, your child may vomit a little blood.
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Your child may also pass a dark stool tomorrow from swallowed blood.
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Call Your Doctor If:
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Can't stop bleeding with 10 minutes of direct pressure done correctly
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You think your child needs to be seen
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Your child becomes worse
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And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
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.
Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.