NOSEBLEED (Epistaxis) |
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NOSEBLEED (Epistaxis)
DESCRIPTIONNosebleed is bleeding from the nose. The blood vessels (arteries and veins) in the nose are involved. In children, nosebleeds occur close to the nose opening. In adults, they usually occur deeper in the nose. Nosebleeds are twice as common in children as adults.
Appropriate health care includes:
Self-care (see HOME CARE).
Doctor's treatment or emergency-room treatment if self-care is unsuccessful. Gauze packing may be inserted to absorb blood, stop dripping, and exert pressure on the ruptured blood vessels. Continued bleeding may require cauterization (See Glossary).
Surgery (for severe bleeding only) to tie off the artery feeding the bleeding areas.
SIGNS & SYMPTOMS
Blood oozing from your child's nostril. If the nosebleed is close to the nostril, the blood is bright red. If the nosebleed is deeper in the nose, the blood may be bright or dark.
Lightheadedness from blood loss.
Rapid heartbeat, shortness of breath, and pallor (with significant blood loss only).
CAUSES
Injury to the nose or nasal polyps--even simple injury caused by picking the nose.
Nasal or sinus infection.
A foreign body in the nose.
Scarlet fever.
Malaria or typhoid fever.
Dry mucous membranes in the nose from any cause.
High blood pressure.
Bleeding tendencies associated with aplastic anemia, leukemia, thrombocytopenia,
or liver disease.
RISK FACTORS
Any disorder listed as a cause; Hodgkin's disease; scurvy; rheumatic fever; blood disorders, including leukemia and hemophilia; use of certain drugs such as anticoagulants, aspirin, or prolonged use of nose drops; exposure to irritating chemicals; high altitude or dry climate.
PREVENTING COMPLICATIONS OR RECURRENCE
Urge your child to avoid injury to the nose if possible.
Obtain medical treatment for the underlying cause of your child's nosebleed.
Humidify the air in your home if you live in a dry climate or at a high altitude.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies.
POSSIBLE COMPLICATIONSBleeding severe enough to require transfusion.
PROBABLE OUTCOME
Your child's symptoms can be controlled with treatment. Severe bleeding requires hospitalization and usually is caused by an underlying disorder, such as liver disease, blood disease, or hypertension. In these causes, the underlying disorder should be treated also.
TREATMENT
HOME CAREInstructions for your child:
Sit up with head bent forward.
Clamp nose closed with fingers for 5 uninterrupted minutes. During this time, breathe through mouth.
If bleeding stops and recurs, repeat--but pinch nose firmly on both sides for 8 to 10 minutes. Holding nose tightly closed allows the blood to clot and seal the damaged blood vessels.
You may apply cold compresses at the same time.
Don't blow nose for 12 hours after bleeding stops to avoid dislodging the blood clot.
Don't swallow blood. It may upset the stomach or make you "gag," causing inhalation of blood.
Don't talk (also to avoid gagging).
MEDICATION
Your doctor may prescribe drugs to treat any underlying serious disorder.
ACTIVITY
Your child can resume normal activities as soon as symptoms improve.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes, when nosebleed has been halted for 24 hours.
CALL YOUR DOCTOR IF
Your child has a nosebleed that won't stop with self-care described above.
After the nosebleed, your child becomes nauseous or vomits.
After the nose has been packed, your child's temperature rises to 101F (38.3C) or higher.
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