OHSU

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
  • 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

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR

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, but not urgently

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

HOME CARE ADVICE FOR NOSEBLEED

Reassurance:

  • Nosebleeds are common.
  • You should be able to stop the bleeding if you use the correct technique.

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.

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.
  • 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.

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.

Call Your Doctor If:

  • Unable to stop bleeding with 20 minutes of direct pressure
  • Your child becomes worse

Disclaimer: This information is not intended 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.

 

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

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