How to care and handle when a child has a nosebleed at home

This article is professionally consulted by Resident Doctor, Doctor Nguyen Hung Tien - Resident Doctor of Pediatrics - Neonatology - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital. The doctor has more than 8 years of experience in the field of Pediatrics - Neonatology.

Nosebleeds (or nosebleeds in children) is a fairly common, often benign, ENT disease. Although not a dangerous disease, it makes many parents confused in handling or taking them to the hospital when it is not necessary. Children with nosebleeds, if not treated early and let the condition last for a long time, will adversely affect the child's health.

Nosebleeds or nosebleeds are common in most people but are more common in children aged 2-10 years. Nosebleeds in children are divided into 2 types: anterior nosebleeds and posterior nosebleeds:
Anterior nosebleeds
Originating from the front of the nose and accounting for about 90% of cases. The most likely site for bleeding is the Kiesselbach plexus in the lower part of the nasal septum (because it contains many small fragile blood vessels). Usually bleeding on one side, nose blood mainly flows from the front with a small amount. Often happens to children in a dry environment such as using a heater or air conditioner for a long time. Mucosal dryness leads to scaly, cracked, and bleeding nasal septum. Posterior nosebleed
accounts for about 10% of cases, usually occurring in the blood vessels higher and deeper of the nose. Bleeding on both sides, nose bleeds profusely to the back and down the throat, can be life-threatening. Although uncommon, the level of danger is higher because it is more difficult to control, often requiring medical attention. It can also occur in the elderly, high blood pressure or in trauma to the nose and face.

Nosebleeds or nosebleeds are common in most people but are more common in children aged 2-10 years. Nosebleeds in children are divided into 2 types: anterior nosebleeds and posterior nosebleeds:
Anterior nosebleeds
Originating from the front of the nose and accounting for about 90% of cases. The most likely site for bleeding is the Kiesselbach plexus in the lower part of the nasal septum (because it contains many small fragile blood vessels). Usually bleeding on one side, nose blood mainly flows from the front with a small amount. Often happens to children in a dry environment such as using a heater or air conditioner for a long time. Mucosal dryness leads to scaly, cracked, and bleeding nasal septum. Posterior nosebleed
accounts for about 10% of cases, usually occurring in the blood vessels higher and deeper of the nose. Bleeding on both sides, nose bleeds profusely to the back and down the throat, can be life-threatening. Although uncommon, the level of danger is higher because it is more difficult to control, often requiring medical attention. It can also occur in the elderly, high blood pressure or in trauma to the nose and face.

How to give first aid to a child's nosebleed:
Reassure, encourage and comfort the child so that he or she does not panic at the sight of blood. Avoid letting your child lie down or tilt their head back. Squeeze the nose: use the index finger and thumb to squeeze the sides of the nose (the soft tip of the nose) to stop the blood from flowing, instruct the child to breathe through the mouth. Hold both sides of the nose for 5-10 minutes (even if only bleeding on one side). Avoid releasing your hand too often to check if the bleeding has stopped, it takes time for the blood to clot to help stop the bleeding. If desired, you can apply a cold compress or place a cool towel on the base of the child's nose to help the blood vessels in the nose constrict, reducing the bleeding process. Instruct the child to spit out blood that has accumulated in the mouth as swallowing blood can cause nausea. Give your child cool water to drink to remove the smell of blood in the mouth. If bleeding continues, spray both nostrils with a decongestant nasal spray containing Oxymetazolin (Afrin or Rhinex). Avoid tilting your head back and let your child wear a mask to prevent dirt from sticking and causing damage to the nose. Remind your child not to pick his nose with his hands, and instead clean his nose with a clean tissue.

During first aid, parents need to monitor nosebleeds and take their children to medical facilities if they see the following cases:
Nose bleeding even after applying first aid measures for 20 minutes . Children have frequent nosebleeds many times. Bleeding fast or the child has lost a lot of blood (more than 1 cup full). The child is bleeding from an injury or an accident (eg, falling or being punched in the face) The child is dizzy or weak. The child is taking anticoagulants. Children with other systemic diseases affecting blood clotting such as kidney disease, liver disease, hemophilia. Your child has a nosebleed while taking a new medication or has recently undergone chemotherapy. Posterior bleeding (blood flowing down the back of the throat, not out the front of the nose) always needs the help of a doctor. Nosebleeds are accompanied by bruises all over the body or with bleeding in another area, such as in the stool or urine.

To prevent children from having nosebleeds again, parents should note:
Let the child rest and relax for at least 2 hours, with only gentle activities (if necessary). Avoid giving your child hot foods, drinks, or hot baths for at least 24 hours after the nosebleed. The nasal mucosa can be moistened with moisturizing cream or physiological saline. Remind your child not to pick or blow his nose for 24 hours. Children should avoid vigorous activities or high-intensity exercise such as running, throwing, and lifting heavy objects. If the child is constipated, it is necessary to drink plenty of water and increase the fiber content in the diet.

Most cases of nosebleeds in children are benign, the bleeding is small and will usually stop on its own. This condition can be repeated until puberty. If your child has occasional nosebleeds once every few months, the amount is small, the family does not need to be too worried. But if the child has frequent relapses or has bruises on the limbs when a slight collision, the family should take the child to a medical facility, a specialized hospital to examine and rule out other causes.