EPISTAXIS

Epistaxis (nosebleed) occurs quite commonly in children.  The cause can be trauma to the nose, structural abnormalities, bleeding abnormalities or tumors.  However, the most common cause is digital manipulation (picking or scratching the nose).

Nosebleeds often start in the middle of the night, without trauma or nose-picking.  Dry heat is sometimes responsible—it dries out the usually warm, moist nasal passages, which makes them more susceptible to bleeding.   The inflammation of allergy or upper respiratory infection with nasal congestion causes increased epistaxis also, because these conditions increase the blood flow to the nasal passages.

The bleeding is most commonly from the anterior (front) part of the nose.  Many blood vessels meet in the anterior septum, and this area is more exposed than other areas to finger manipulation and dry air.

The best way to stop a nosebleed at home is to pinch the front of the nose and hold the nostrils shut for at least five minutes.  It is best not to check to see if the bleeding has stopped during this time; if you do, the clots will break up and the bleeding will begin again.  After five to ten minutes, slowly release the pressure and check to see if the bleeding has stopped.  If it has, the child should be kept quiet and instructed not to touch his/her nose for a period of time.  If it hasn’t, try the technique again.  If you are still unable to stop the bleeding , call our office.  We may need to refer you to an ENT (ear, nose and throat) specialist, who may need to cauterize the bleeding site.



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