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NOSEBLEED in Kids: 3 THINGS YOU NEED TO KNOW(+A home care checklist download)

Nosebleed  in children are worrying.Causes may be many and management of pediatric nose bleeds can be tricky .Read about nose bleed in adults here .

As a parent, it’s heartbreaking and you feel terribly upset.

It’s actually very common.

And not as worrying as it looks.

As an ENT surgeon nosebleed are some of the most frequent emergencies we attend.

The most important advice in cases involving children is rarely medicine.

I felt a little info about first aid home care for nosebleed would be useful.

Why does it happen?

Most  often it’s  due  to nose picking.

Nose picking is easily the most common reason   for nosebleed in children.

Luckily nosebleed in children are hardly ever life threatening.

But just knowing the why is not good enough .

Parents need to be aware of  danger signs.

The signs below  show when you need to visit the emergency.

#IMPORTANT TIP 1

THE DANGER SIGNS WHICH YOU SHOULD KNOW

Doctors will focus more on the child’s breathing and  hemodynamic stability  ,than the nosebleed.

This means the child might need intravenous fluid support, blood transfusion, moist oxygen inhalation

Identification of the site and cause of nosebleed, is of importance only after making the child stable.

 WHAT CAUSES  NOSEBLEED

IN CHILDREN:

WHAT COULD BE THE CAUSE OF FREQUENT NOSEBLEED IN CHILDREN?

Mostly systemic causes

A study   had found at least 1 episode of nosebleed occur

Child abuse is another worrying cause of recurrent nosebleed in children.

That’s a potential red flag for healthcare providers.

50% Adults with nose bleeding  has the history of nosebleed during childhood.

#IMPORTANT THING NO.2

WHAT IS THE BEST WAY TO STOP A NOSEBLEED AT HOME?

Stop nose bleed :first aid

How to stop Nose bleed

Make your child sit down  and bend forward and pinch the soft part of their nose.

ANTERIOR EPISTAXIS

Nosebleed in children most commonly occurs from the front part of the nose.

This is known as anterior epistaxis.If its not  controlled at home you might need to visit, the emergency of your nearest hospital.

Little’s area is the commonest site of anterior nose bleed in children

WHAT OTHER WAYS WILL THE DOCTOR STOP THE NASAL BLEEDING

CAUTERY

CHEMICAL CAUTERY

Anaesthesia – LA

TECHNIQUE

Disadvantage

ELECTRIC CAUTERY

CARE AFTER CAUTERY

ANTERIOR PACKING

INDICATION

MATERIAL USED

INDICATION

Mechanism of action:All the absorbable packs  help the blood to clot .They give a matrix for the platelets and fibrin particles interlinks. This way the bleeding from the nasal cavity can be stopped

ADVANTAGE

MEROCEL PACK: This is in between an Absorbable nasal pack and ribbon gauze.This is made of biocompatible , polyvinyl alcohol sponge material  which helps to stop bleeding .It has a very high-capacity for absorption .

Provides a mild pressure and tamponade effect after insertion in the nasal cavity .This tamponade effect helps to stop the bleeding.

It may be kept for upto 5 days , but under antibiotic cover.

Advantage:

Disadvantage:

It’s expensive.

Nasal bleeding which needs high tamponade effect to stop , may not be controlled

RIBBON GAUGE PACK

– Layered placement of the pack  filling

ANTERIOR NASAL PACKING FOR NOSEBLEED

COMPLICATION OF ANP

DURING PACKING

WHILE PACK IS PREVENTION IN THE NASAL CAVITY

DURING REMOVAL OF PACK

Posterior nosebleeds:

Originate toward the back of the nasal passage, near the throat.Occurs mostly in elderly as hypertensive epistaxis. 

Posterior nosebleeds are less common than an anterior nosebleed. But they can be serious and can cause a lot of blood loss. Children do not usually get posterior nosebleeds.

But  if it does occur, they can be serious .Posterior epistaxis can cause significant blood loss and collapse.

In children  it   can occur following trauma  to nose.

This causes the nasal bone to  break and injury to the sphenopalatine artery .This sphenopalatine artery at the back of the nose can cause profuse bleeding.Thus is a serious emergency and needs urgent medical intervention.

 

HOW CAN FREQUENT NOSEBLEED IN CHILDREN  BE MANAGED?

Consultation with your doctor is important in case of frequent nosebleed.

Careful history: Generally there is the history  of  prolonged bleeding after minor trauma, teeth extraction etc.

The child may be having other signs of frequent bleeding:

Investigation:

Treatment:

#IMPORTANT THING NO.3

NOSEBLEED PREVENTION

If your child  gets nosebleeds frequently.After a full checkup if you find its due to nasal crusts and nosepicking.

There are a few things which you can do to help stop nasal crusting.

The less the crust, less will be the childs tendency to pick his/her nose.

Te following measures will help reduce  drying and crusting.This in turn will significantly decrease the nose picking and the chances of getting a nosebleed:

I hope you found this post helpful.

Please share and help another parent.They will thank you for this.

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