The epistaxis o nosebleeds they are very cumbersome, but usually they are not seriousAlthough the causes are diverse and some children are more prone than others, it is a common situation that can be managed. calmly and with correct technique. It is surprising that, despite the common nature of the problem, Many people do not know how to properly treat a nosebleed. and dangerous myths still persist.
Below I explain what should be done, what shouldn't be done, and why. A key preview: nosebleeds do not get blockedPlacing cotton or handkerchiefs inside the pit and tilting the head back is, in addition to being ineffective, potentially dangerous.
Why nosebleeds or epistaxis occur
Nosebleeds are very common because the nose is full of small blood vessels that are easily injured. The air that circulates through the nose can dry and irritate the membranes internal and, when scabs form, they can bleed if they become irritated. This occurs more in dry environments (heating, arid climates) and in children sensitive to epistaxis, especially in older ages 3 and 10 years between.
Most of these hemorrhages originate in the front of the partition (anterior epistaxis, Kiesselbach's plexus) and are usually unilateral and easy to stop. Less commonly, bleeding originates in the deep part (posterior epistaxis): it is less common in children and more difficult to control.
The most common causes include irritations (allergies, colds, sinus problems, sneezing), cold or dry air, blow your nose loudly or pick your nose, scams or fractures, strange bodies, deviated septum, abuse of nasal sprays or long nails that injure the mucosa. They can also promote bleeding. vigor in sports without protection (nasal contact/trauma) and certain drugs (antihistamines and decongestants that dry out; anticoagulants/antiplatelets that facilitate bleeding).
It must be considered that repeated nosebleeds They may be a clue to other conditions (e.g., coagulation disorders such as von Willebrand disease or hemophilia, vascular malformations, polyps or vegetations, rarely tumors such as juvenile nasopharyngeal angiofibroma). It is not usual, but if they are repeated often, it is advisable consult with the pediatrician.
How to deal with a nosebleed
Acting is simple, but it requires two things: tranquility y patience. Stay calm, take your time, and follow the correct method consistently. Using a watch or timer helps respect time pressure.
We insist: do not plug when blood begins to flow. More than a lack of information, there is usually a lack of calm and patience necessary.
Let's Step by Step and explaining why.
Step # 1 - Place the child's head forward
Yes, forward, and let the blood come out. Place something underneath to catch it and calms the child. Tell him that breathe through your mouth and remind him that you are in control of the situation.
If they see you confident, it will be easier. You may have to stand firm because this contradicts "the old way." Then you can explain why he doesn't tilt his head back.
Tilt your head back has risks: Blood may flow back into the throat and cause cough, nausea, and vomiting, obstruction breathing and annoying clots when swallowing, even more so if there are mucus.
Step # 2 - Gently blow your nose
It seems counterintuitive, but it helps: when bleeding starts, the blood begins to clot and clots form that can accumulate. With the boogers are made large plugs. Also, if the child tilted his head back at the beginning, there will be clots in deeper areas. soft blowing initial blow away those remains. After that blow, don't blow your nose again in several hours to avoid reactivating the bleeding.
What if you put a plug in? They form again. annoying clots which will then go inwards or outwards, leaving dried remains that often cause further bleeding when detached.
Step # 3 - Gently press down on the soft part of the nose
With your thumb and index finger, press the bottom half of the nose (the soft part, just under the bone). Maintain pressure continues for 10 minutes with your head neutral or slightly down. Without lifting to “look”. The time may seem long, but it is what allows the clot stabilizes (usually 7–15 minutes). If it persists, perform a second set of another 10 minutes.
You can use a clean handkerchief or gauze to grab, and a cold compress or ice wrapped over the bridge of the nose (never inside). The cold helps, but does not replace to the continuous pinch. If to the 20 minutes well done if the bleeding does not stop, contact a professional.
When it stops, ask the child to avoid efforts, do not touch or blow your nose for the rest of the day. During 24–48 hours, Better do not do contact sports, do not take very hot showers or lower your head too much, and sleep with your head head slightly raised.
Can I use a vasoconstrictor spray?
En some cases and only with pediatric indicationIn older children, a topical vasoconstrictor may be considered to control stubborn epistaxis. Without medical advice, do not use it, especially in minors, by Adverse effects and for the risk of worsen drynessThe basis of home management remains the direct pressure and nasal hydration measures; if appropriate, consult about cortisone for children.
Common mistakes to avoid
- Do not tilt head back or lay the child down.
- No tapes the grave with handkerchiefs, cotton balls or other objects.
- Do not obsess with clearing clots; a gentle initial blow is sufficient.
- Do not use vasoconstrictor sprays without pediatric indication.
- Do not let Do not pick your nose or blow it loudly for hours after the episode.
- Do not interrupt pressure to check if it has stopped; you will restart the bleeding.
When to go to the pediatrician or emergency room
The majority Bleeding is controlled at home. Consult if any of these signs appear:
- It lasts more than 20 minutes despite correct pressure, or reappears immediately after two sets.
- It is very abundant, there is dizziness, weakness, paleness, sweating or drowsiness.
- It occurs after a blow in the nose or head, or suspicions fracture.
- Bleeding from both nostrils and blood comes out of the mouth, or there is vomiting blood or dark “coffee grounds” type material.
- Has started new medication (anticoagulants/antiplatelets) or appear bruises, bleeding gums or other locations.
- Suspected foreign body (small child, unilateral, bad smell, purulent discharge).
- It is repeated frequently (several times a week) or interferes with daily life.
In children with chronic severe cough (e.g., cystic fibrosis) or with coagulation disorders, any repetition should be assessed by your specialist. If necessary, you will be referred to Otolaryngology to cauterize the bleeding vessel or consider other measures.
Prevention and aftercare
After a nosebleed, a small amount remains. crust that can come loose and reopen the bleeding. Maintain your daily activities, but avoid bumps (judo, rugby, rough play), do not touch or wash heavily in that nostril for a few days. Do not lower your head too much or do intense efforts in 24–48 hours.
- Humidifies the environment at home if the air is dry; a cool mist humidifier at night can help. Keep it cleansed to prevent mold.
- Moisturize the mucosa with saline solution in spray, drops, or gel 2–3 times a day. In some cases, apply a small amount of neutral petroleum jelly at the edge of the pits (without inserting your finger upwards) and remove the excess. See Home Remedies to improve nasal care habits.
- cut the nails and teaches you not to pick your nose.
- Avoid blowing your nose loudly and sneezing with the mouth closed. If there is allergies, treat them to reduce irritation.
- Usa protección in contact sports (helmet/mask) when appropriate and avoid excessive force without protection that could injure the nose.
If the bleeding was nocturnal, the child may have swallowed blood while sleeping; it may cause vomiting or dark stools. This isn't usually serious if the episode has subsided, but discuss any persistent symptoms with your pediatrician.
Types of nosebleeds: anterior and posterior
The most common type is the previous, which affects the front of the nose (Kiesselbach's plexus). The capillaries are fragile and break easily; they are usually unilateral and respond to the direct pressure.
La posterior It occurs in deep areas; the blood can go down the throat even when sitting. It is very rare in children and more common in older adults or those with hypertension or after trauma. If you suspect posterior epistaxis (very heavy bleeding from both nostrils and mouth, uncontrolled with pressure), go to the emergency room.
Frequently asked questions
How long does “normal” last? The most common is that it is cut in 10 minutes of constant pressure (sometimes up to 15). If it continues, repeat another set of 10, and if it persists, consult.
Why does it sometimes bleed at night? During sleep, the mucosa parched and small scabs may come off. The child may swallow blood while asleep and vomit it up upon waking; it is not usually serious if the bleeding has already stopped.
Does hypertension cause epistaxis in children? In pediatrics it is not a common cause. Infant epistaxis is usually due to dryness, irritation or manipulation. However, if there are other accompanying symptoms, consult a doctor.
How do I suspect a foreign body? Warning signs: bleeding or discharge unilateral persistent, sometimes with odours, or episode after episode with small pieces. Don't try to remove it: go to the pediatrician or ENT doctor.
Teach your child what to do
If your child has frequent nosebleeds, explain what to do and why. You won't always be there to help, and this way, they'll learn to keep calm. Reinforces a simple script: “Head forward, soft blowing, pinch 10 minutes, breathe through your mouth, tell an adult.” Praise your child's self-control and remind them that do not touch the nose afterward. If you're in school, ask teachers to follow these guidelines and avoid inappropriate practices such as tilting the head back or inserting cotton balls.
Nosebleeds in childhood are frequent and manageable. Keep calm, apply a correct and continuous pressure and avoiding myths such as throwing your head back or blocking are the key. Added to good habits Nasal hydration, short nails, and allergy treatment reduce relapses. If you experience warning signs (heavy or persistent bleeding, bleeding after trauma, or poor general condition), consult your pediatrician or pediatric ENT specialist without hesitation for a complete and thorough evaluation.
