* Bleeding from 1 or both nostrils
* No known injury
• Nosebleeds are common because of the rich blood supply of the nose. Common causes include
– Dryness of the nasal lining (eg, from forced air furnace in winter)
– Antihistamines (Reason: they also dry the nose)
– Vigorous nose blowing
– Ibuprofen (eg, Advil) 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 (eg, nasal allergies, colds, sinus infections)
Fainted, or too weak to stand
Call Your Doctor Now (or in Alberta, Canada call 780-408-LINK) 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
Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm) If:
You think your child needs to be seen
Call Your Doctor During Weekday Office Hours If:
* You have other questions or concerns
* Child is younger than 1 year
* 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
* 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 centre 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 it re-bleeds, use the same technique again.
3. Insert Gauze:
* If pressure alone fails, insert a gauze wet with a few decongestant nose drops (eg, nonprescription Afrin) (Reason: the gauze helps to apply pressure and nose drops shrink the blood vessels).
* If not available or your child is younger than 1 year, 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 centre 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 (eg, Advil) (Reason: increase bleeding tendency)
5. Expected Course: More than 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
Based on recommendations/advice in “My Child is Sick; Expert Advice for Managing Common Illnesses and Injuries”, 14th Edition, by Barton D. Schmitt