Nosebleed  
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First Aid - Nosebleed
First Aid - 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
  • Ibuprofen and aspirin (Reason: increase bleeding tendency)
  • 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

If not, see these topics

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

  1. Reassurance:
    • Nosebleeds are common.
    • You should be able to stop the bleeding if you use the correct technique.
  2. 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.
  3. 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.
  4. 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.
    • Avoid aspirin and ibuprofen (Reason: increase bleeding tendency).
  5. 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.
  6. Call Your Doctor If:
    • Unable to stop bleeding with 20 minutes of direct pressure
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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.