A nosebleed can be a frightening experience. Doctors at the Great Ormond Street Hospital show how you can cope with the condition in our latest A-Z health guide
What are they?
Nosebleeds are common in children and the elderly. They can be scary but are rarely dangerous or a cause for concern. The nose is particularly susceptible to bleeding because it has lots of tiny blood vessels that lie close to the surface of the skin, making them prone to injury. In most cases bleeding comes from one nostril and lasts around five to 15 minutes, followed by a blood-tinged mucus that can last for a couple of days.
What are they caused by?
The most common cause of nosebleeds in children is the combined dryness from indoor heat in winter and nose picking. Picking becomes more frequent when mucus in the nose becomes dry and itchy. Other likely factors are injury to the nose, sneezing, and vigorous nose blowing which can trigger bleeding. Other less common causes include:
- Foreign bodies lodged in the nose (beads, peas and pebbles)
- Allergies (hay fever)
- Infections
- Facial and nasal surgery
- High blood pressure
- Drug taking (cocaine)
- Blood clotting (associated with the elderly)
- Hardening of the arteries (associated with the elderly)
How can I prevent nosebleeds?
- Keep the lining of the nose moist. For older children you could dab a coat of Vaseline inside the nose with a cotton swab or apply a nasal spray. However, Vaseline is not recommended for babies and very young children as it could block the nostril.
- Stop the drying effects of indoor heating by using a humidifier, preferably a clean one to prevent mildew.
- Avoid placing your child's bed too close to radiators or heaters.
- Cut your child's nails short to prevent damage if picking.
- Stop smoking. Smoke causes irritation to the nose.
Which nosebleeds are dangerous?
Most nosebleeds occur in the front part of the nose. However, there are some that stem from large vessels in the back of the nose, and these can be quite dangerous. The elderly are most likely to suffer this type of nosebleed, which is often a sign of high blood pressure, daily aspirin use or bleeding disorders.
Treatment
Most nosebleeds can be treated with simple first aid measures.
Step 1: Stay calm and reassure the child - most children dislike the look and taste of blood.
Step 2: Sit the child up, making sure they lean forward slightly. Try to keep their head above their heart, which will help to stop the bleeding. It will also prevent the child from swallowing blood, which can cause nausea, vomiting and diarrhoea. It is best to do this over a basin with running water so the blood is continually washed away.
Step 3: Ensure the mouth is held open so that blood does not obstruct the air passage. Using your thumb and index finger, pinch the lower part of the nostrils (the soft part just below the bridge) for about ten minutes so that the child can breathe through the mouth.
Step 4: After ten minutes the nostrils should be released slowly.
Step 5: Do not wipe or blow the nose, and discourage physical play for a couple of hours.
See your doctor if:
- The bleeding goes on for more than 15 minutes. It could be that your child has a fragile blood vessel or blood clotting, although the latter is rare.
- The bleeding was caused by an injury to the nose or blow to the head. A nosebleed after a fall or car crash could be the sign of internal bleeding.
- Nosebleeds occur more than once or twice a week.
Your doctor will find out where the bleeding is coming from. If the nosebleed does not stop, your doctor may cauterise the bleeding vessel, after applying local anaesthetic. Alternatively, he could pack the nose with gauze or an inflatable balloon so that enough pressure is placed on the vessel to make it stop bleeding - although he is more likely to do this with an adolescent than a young child.
