First Aid for Nosebleeds

What is a Nosebleed?

A nosebleed, medically known as epistaxis, is a common condition where blood flows from the nostril, nasal cavity, or nasopharynx. The nasal passage is rich in blood vessels, making it particularly susceptible to bleeding. Nosebleeds can be categorised into two types: 

• Anterior nosebleeds, which are the most common, originate from the front of the nose and are usually not severe. 
• Posterior nosebleeds, originating from deeper within the nasal cavity, are less common but can be more serious.

What Causes Nosebleeds?

Nosebleeds can be triggered by various factors, including:

• Dry climates or heated indoor air can dry out the nasal membranes, making them more prone to bleeding.
• Frequent nose blowing, picking, or rubbing can irritate the nasal lining.
• Upper respiratory infections and sinusitis can cause nasal tissues to become inflamed and bleed.
• Allergic reactions can lead to inflammation and congestion, increasing the risk of nosebleeds.
• A direct blow to the nose or a foreign object in the nostril can cause bleeding.
• Certain medications, such as blood thinners, can increase the likelihood of nosebleeds.
• Conditions like high blood pressure, blood clotting disorders, or nasal structural abnormalities can contribute to frequent nosebleeds.
• Children, in particular, may insert objects into their noses, which can cause injury and bleeding.
• Exposure to certain chemicals, including tobacco smoke, can irritate the nasal passages.

What Should I Do Immediately?

The following steps can help manage and stop the bleeding:

• Stay Calm: Keeping calm can help control the situation, especially when dealing with children.
• Sit Upright: Have your child sit down and lean slightly forward. This helps prevent swallowing blood, which can cause nausea.
• Pinch the Nostrils: Using your thumb and index finger, pinch the soft part of the nostrils together and hold for about 10 minutes. Breathe through the mouth.
• Use a Cold Compress: Apply a cold compress or an ice pack to the bridge of the nose to constrict blood vessels and reduce bleeding.
• Avoid Irritation: After the bleeding stops, avoid blowing or picking the nose for several hours to prevent re-bleeding.
• Maintain Humidity: Use a humidifier to keep the air moist, particularly in dry environments.

When Does My Child Need to See a Doctor?

Certain situations that require medical attention are:

• Frequent Nosebleeds: If your child experiences frequent nosebleeds, it may indicate an underlying condition that needs to be addressed.
• Heavy Bleeding: If the bleeding is heavy or difficult to stop, it’s essential to consult a healthcare provider.
• Associated Symptoms: If nosebleeds are accompanied by symptoms such as bruising, bleeding from other areas, or signs of infection (e.g., fever, swelling), seek medical advice.
• Foreign Objects: If a foreign object is stuck in your child’s nose, do not attempt to remove it yourself. Seek medical help.
• Medical History: Children with a history of clotting disorders or on blood-thinning medications should be evaluated by a doctor if they experience a nosebleed.

When Should I Call Emergency Services?

In certain scenarios, it is crucial to call emergency services immediately:

• Uncontrollable Bleeding: If the bleeding does not stop after 20 minutes of applying pressure, seek emergency help.
• Significant Trauma: If the nosebleed is a result of a significant injury or accident, especially if there are signs of a broken nose or head injury, call for emergency assistance.
• Difficulty Breathing: If the nosebleed is causing difficulty in breathing or the child is choking on blood, call emergency services.
• Signs of Shock: Symptoms such as pale skin, rapid heartbeat, shallow breathing, or confusion indicate shock and require immediate medical attention.

How to Prevent Nosebleeds?

Preventive measures can reduce the likelihood of nosebleeds:

• Use a humidifier in your home to keep the air moist, especially during winter months.
• Apply a thin layer of petroleum jelly or saline nasal spray to the inside of the nostrils to keep them moist.
• Minimise exposure to irritants such as smoke and strong chemicals. Keep children’s nails trimmed to prevent injury from nose-picking.
• Keep allergies under control with appropriate medications and minimise exposure to allergens.
• Ensure children wear protective gear during sports or activities that pose a risk of nasal injury.
• Encourage adequate fluid intake to keep mucous membranes hydrated.
• Encourage gentle nose blowing and avoid excessive force.