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Nosebleeds: When to Seek Help
by Lynn Cates, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.
Even though most nosebleeds stop by themselves or after you apply pressure, sometimes you will need to seek professional advice. In those cases, you can either call your child's practitioner or, if he isn't available, take your child to an emergency room. Once you arrive, you might hear someone mention epistaxis (pronounced "epah STACKS us). This is just the medical term for nosebleed.
You should consult a healthcare provider if:
- your child has trouble breathing. If it looks like your child is having difficulty breathing, you should call for help immediately.
- your child faints or looks sweaty and pale. If your child faints or looks sweaty and pale to you, especially if her nose is bleeding profusely, or has been bleeding for a long time, you should call for help. It is very unusual for nosebleeds to cause serious blood loss in otherwise healthy children (even though it often looks like a lot of blood!), but in rare cases the blood loss can be significant.
- your child had head trauma. If the nosebleed is due to an injury to the head or face (e.g., a blow or fall) there is a possibility of other damage like a concussion, so you should have your child checked.
- the bleeding doesn't stop. If you have been able to hold your child's nose for a full 10 minutes twice and the bleeding hasn't stopped, it's time to call for help. There are several other measures healthcare professionals can try, including inserting gauze moistened with medicine to help stop bleeding into the nose, sealing the bleeding vessel by cauterizing it (gently burning it with silver nitrate on the tip of a tiny cotton swab), or packing the nose with a very long piece of special gauze.
- the nosebleeds keep coming back. You have probably found that if your child has one nosebleed, he is more likely to have more over the next few days. This is because the blood vessel's wall hasn't had time to heal completely and is easily re-injured by blowing, rubbing, or picking the nose. Usually just being gentle with the nose for a few days, or applying a little petroleum jelly, interrupts this cycle and allows the vessel to heal. If the nosebleeds keep coming back, however, you should call for advice.
- you suspect the nose is broken. It can be hard to tell if someone's nose is broken, but if it looks crooked or swollen, or if you have any other reason to suspect that it is broken (e.g., your child was hit in the nose with a baseball), you should have her checked.
- you suspect something is lodged in the nose. Children often explore their bodies by sticking small objects into any available orifice. Whether it's a pea or a wad of toilet paper (for some reason, this is a favorite!), it can cause irritation and lead to a nosebleed. If your child's nosebleed is accompanied by a foul-smelling yellowish-green discharge from one nostril, it is a good idea to have your child's nose checked for the possibility of a foreign object.
- there is other bleeding or bruising. On occasion, recurrent nosebleeds are a sign of a serious underlying disease. If you are concerned that your child is having too many nosebleeds, that they are too hard to stop, or that the bleeding is too heavy; or if your child has other bleeding (e.g., his gums when he brushes his teeth) or is bruising more than normal, you should bring this to her practitioner's attention.
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Created December 07, 2001
Reviewed December 10, 2001
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