Nose bleeds are when the small fragile blood vessels in the nose break. This will cause the nose to bleed. It is a common condition, especially in young children. Children who have frequent nosebleeds should be checked for underlying conditions by a doctor.
What causes nose bleeds?
Nosebleeds are pretty common, especially in young children. This is because the blood vessels in the nasal lining are close to the surface and quite fragile. They can rupture easily.
A bump or bang on the nose can often result in a nosebleed. Young children often play very physical games, whether it’s rushing around on the playground at nursery or school or tumbling about at home. Bumps on the nose can be pretty common.
If a child picks their nose or blows it too vigorously, this can also start a nosebleed.
Sometimes even a violent sneeze can damage the nasal blood vessels, and trigger a nose bleed.
While nosebleeds are rarely dangerous, very occasionally, a nosebleed can indicate a more serious underlying problem like a head injury.
What are the signs and symptoms of nose bleeds?
If a child has a nosebleed after suffering from a bump on the head, it’s important to look carefully for other signs that might indicate an underlying injury.
If the child has any of the following symptoms emergency medical advice should be sought;
Confusion, drowsiness, nausea and vomiting
losing fluid through their nose that is thin and watery
How are nose bleeds treated?
If a child has a nose bleed, the recommended course of action is:
· Ask the child to sit down with their head tilted forward.
· Get them to breathe through their mouth.
· Put a bowl under the nose and give them tissues or a cloth.
· Ask them to pinch the front, soft part of their nose for 10 minutes – or pinch it for them if it is a young child.
· If tolerated, apply an ice pack to the affected area
· After 10 minutes, release the pressure – if the bleeding has not stopped, reapply the pressure for up to two further periods of 10 minutes. Once the bleeding stops gently clean the area.
· Do not tilt the child’s head backwards. This will not stop the bleeding and can cause blood to trickle down their throat. This can make them sick and affect their ability to breathe.
When to ask for medical help about nose bleeds
If the bleeding does not stop after 30 minutes, it’s best to take the child down to your local Emergency department for expert advice.
· Some children do seem more prone than others to frequent nosebleeds. If a child does seem to suffer from them more than twice a week, it’s advisable to see a doctor.
· It’s important in the first instance to rule out an underlying bleeding disorder.
These are quite rare. The child’s doctor will ask whether the child has a history of prolonged bleeding from other areas, for instance when losing a tooth, and about whether they bruise easily.
· Bleeding disorders do run in families so if there is a family history of this, the child may be susceptible.
· The doctor may recommend blood tests. These may include a full blood count to check that frequent nosebleeds have not caused the child to become anaemic, and also to screen for any underlying bleeding disorders.
· Another more common explanation for frequent nosebleeds is that the child may have picked their nose causing blood vessels in the septum, the cartilage which divides the nostrils, to bleed.
· The doctor can also check for any signs of infection. If there is any infection, the doctor will probably prescribe a course of ointment with antibiotic and anti-inflammatory properties. This should be applied for up to two weeks.
If the child can resist touching or picking the affected area it should clear up completely within this time.
· The doctor may also suggest referring the child to ENT (ear, nose and throat) surgeon who would be able to examine the back of the child’s nose thoroughly, if necessary, to check for any underlying cause for the problem.
For instance, a child who has a deviated septum is more likely to suffer from nosebleeds. A deviated septum means that the septum is slightly bent, usually as a result of injury (for instance a sports injury or an injury sustained during birth).
· The deviated septum causes abnormal airflow through the nose which causes the lining of the septum to dry out and bleed easily.
· There are also some extremely rare conditions linked with persistent nosebleeds.
The ENT doctor would also be able to discuss further treatment options.
One possibility is cauterisation which involves touching the affected area gently with silver nitrate which seals off the bleeding blood vessel by way of a chemical reaction and means it should bleed less.
What happens next?
Most children, even those who suffer from frequent nosebleeds, tend to outgrow it. Nosebleeds can also happen in adult life but it is less common.
*Information courtesy Dr. Farrukh Sheikh