Tag Archives: home care advice

Nose bleed

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 (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)

Call 911 Now (Your Child May Need an Ambulance) If:

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

Home Care Advice for Nosebleeds:

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 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

Crying

Definition:
Excessive crying, irritability, or fussiness in a child 3 months or older.
Child is too young to tell us or show us the cause for his crying. Crying is the only symptom.
If your child is crying from an illness or physical symptom, use that symptom checker instead of this one.

Causes:
Not caused by hunger—by this age, you should be able to recognize hunger. Main Cause: Coming down with an illness. Other Common Causes: * Overtired, stressed, whining, tantrums, and separation anxiety. * Always consider pain as a possible cause of persistent fussiness or crying. Inconsolable crying may be the only symptom initially in a young child with an ear infection or even appendicitis. * Painful causes include earache, blocked nose from a cold, sore throat, mouth ulcers, raw diaper rash, metal ulcer on tip of penis, constipatio, and hair wrapped around toe (take off socks and check).

Call 911 Now (Your Child May Need an Ambulance): If Not moving or very weak

Call Your Doctor Now (or in Alberta, Canada call 780-408-LINK):

* IF Your child looks or acts very sick

* Stiff neck or bulging soft spot

* Possible injury (especially head or bone injury)

* Very irritable, screaming child for longer than 1 hour

* You are afraid you or someone might hurt or shake your baby

* Your child cannot be comforted after trying this advice for 2 hours

* Crying interferes with sleeping for longer than 2 hours

Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm)

* If you think your child needs to be seen

* Pain (eg, earache) suspected as cause of crying

Call Your Doctor During Weekday Office Hours

* If you have other questions or concerns

* Mild, off-and-on fussiness (acts normal when not crying) continues more than 2 days

* Excessive crying is a chronic problem

Parent Care at Home If mild fussiness present fewer than 2 days and you don’t think your child needs to be seen

Home Care Advice for Mild, Consolable Crying:

1. Reassurance: Most infants and toddlers become somewhat irritable and fussy when sick or overtired. Crying tells us your child is not feeling well. If the crying responds to comforting, it’s probably not serious.

2. Comforting: Try to comfort your child by holding, rocking, or massaging her

3. Sleep: If your child is tired, put him to bed. If he needs to be held, hold him quietly in a horizontal position or lie next to him. Some overtired infants need to cry themselves to sleep

4. Undress Your Child: Sometimes part of her clothing is too tight or uncomfortable. Also check her skin for redness or swelling (eg, insect bite)

5. Discontinue Medicines:

* If your child is taking a cough or cold medicine, stop it

* The crying should stop within 4 hours

* Antihistamines (eg, Benadryl) can cause screaming and irritability in some children

* Pseudoephedrine (decongestant) can cause jitteriness and crying

6. Expected Course: Most fussiness with illnesses resolves when the illness does. Most fussiness caused by stress or change (eg, new child care) lasts less than 1 week

7. Call Your Doctor If:

* Constant crying lasts longer than 2 hours

* Intermittent crying lasts more than 2 days

* 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