Nosebleeds: Why We Get Them and the Proper Way to Treat Them

Nosebleeds can be frightening, especially when your own child suffers one. However, most are not serious. Some will stop on their own; others will stop after administering a few simple first-aid steps. The American Academy of Otolaryngology- Head and Neck Surgery tells us that nosebleeds “…are most common in children aged 2-10 years and adults aged 50-80 years”.

If you or a family member suffer from nosebleeds, here is what you need to know.

There are two types of nosebleeds: anterior and posterior. 
Anterior Nosebleeds: The most common type of nosebleed begins in the lower part of the nose where a wall separates the nostrils and is called an anterior nosebleed. There are many blood vessels in the nose and when they are broken, they bleed; sometimes beginning in just one nostril. These types of nosebleeds can be caused by dry air inside or outside of the home, or by inadvertently scratching the inside of the nose. (In children a frequent cause of nosebleeds is nose picking.) It can also be caused by acute sinusitis and allergies.

Posterior Nosebleeds: A posterior nosebleed is much more serious and occurs when the back of the nose is damaged. The blood may come out of the nose but it may also flow into the throat. Just like an anterior nosebleed, it can be caused by damage to the nose, but it can also be caused by high blood pressure or other health conditions. If your nose has been bleeding for more than 20 minutes or occurs as the result of a head or face injury, you may be suffering a posterior nosebleed.

What to do in case of a nosebleed
It is important to try to determine if the person is suffering an anterior or posterior nosebleed. Since anterior nosebleeds aren’t dangerous, it is most important to determine if the person is exhibiting the signs of a posterior nosebleed which are as follows:

• When standing up, blood is flowing down the throat
• The person has suffered a facial or head injury, or has been in a car accident and has a nosebleed as a result
• The person is over the age of 50 or under the age of two
• The person has high blood pressure
• The nosebleed prevents the person from breathing normally
• The nosebleed continues for more than 20 minutes, despite putting pressure on the nose

If any of these exist, it is important that the person be seen by a doctor as quickly as possible.

First aid for nosebleeds
Treatment for anterior nosebleeds is much simpler and involves simple first aid. If you or someone you are with suffers an anterior nosebleed, follow these steps:

• Sit straight up, don’t lean over. You can lean forward a bit to avoid swallowing blood, but don’t lean over the knees. Sitting straight up will reduce the flow of blood to the small veins inside your nose
• Blow your nose. Blow your nose gently to remove any blood that may have clotted inside it
• Pinch the nose with your thumb and index finger. Pinch both nostrils and push them up toward your face and breathe through your mouth. Even if just one side is bleeding it’s important to pinch both sides of the nose for five or ten minutes to stop the flow of blood
• If the bleeding doesn’t stop, repeat these steps for up to 15 minutes

What to do after a nosebleed

• Once the bleeding has stopped, apply ice to the nose and the cheeks on either side, but never put ice directly on the skin
• Nasal spray or saline spray can help to prevent the nosebleed from recurring by constricting the blood vessels in the nose
• Keep your head above your heart for at least 30 to 45 minutes to prevent the nose from bleeding again
• Eat cool, soft foods and don’t drink anything hot for 24 hours
• Relax for the next 24 hours; don’t bend over or lift heavy objects
• Avoid taking pain relievers that also thin the blood. They include aspirin, and ibuprofen ( including Advil and other brand names)

Is it possible to prevent nosebleeds?
You can do several things to prevent frequent nosebleeds.

1. If the air where you live or work is dry, try to keep the tissue inside your nose moist. You can do this by placing antibiotic ointment or petroleum jelly on the end of a finger or a Q-tip and rubbing it on the inside of the nose. Be careful not to insert the Q-tip too far. You only need to keep the lower part of the inside of the nose moist
2. Keep the air inside the house moist. If the air inside your home is very dry a humidifier can help to introduce some moisture
3. Trim children’s nails. Keeping a child’s nails short may avoid nosebleeds if they pick their nose. Teaching them not to pick their nose is a good idea as well
4. Stop smoking

If your child suffers frequent nosebleeds
If your child suffers frequent nosebleeds it is important to have him or her checked by an ear, nose, throat (ENT) doctor. It’s important to rule out any hidden causes of the nosebleeds. The doctor will conduct a thorough physical exam and will look into the child’s nose with a lighted scope. The doctor may also order imaging exams like a CT scan. Then a diagnosis will be made about the cause of the chronic nosebleeds.

In the meantime, teach your child the first-aid steps listed above and help them to remain calm during nosebleeds. Notify the school nurse and your child’s teacher about the frequent nosebleeds so they will be prepared should one occur.

Most nosebleeds aren’t harmful to your health, even though they may be frightening to witness. Knowing the signs and symptoms of the different types of nosebleeds and effective first aid steps can help you to address them quickly.

References
1: http://www.entnet.org/content/nosebleeds