The most common spontaneous bleeding is nasal bleeding. They often occur in children of different ages. The reason for hospitalization in the ENT hospital in 10-15 percent of cases is precisely this problem.
Types of nosebleeds in children
Bleeding from the nose can be from the back or front. In the first case, the causes are usually trauma, high blood pressure, or some serious illness. Bleeding from the anterior parts of the nasopharynx is not so dangerous, as it usually occurs when a vessel is damaged, which is located on the septum.
Causes of sudden bleeding
Almost 90 percent of nosebleeds in children are caused by bursting vessels in the anterior sections. Vascular plexuses located superficially in the septum are easily damaged. Also, bleeding may be due to the influence of several negative factors:
- excessive dryness of some parts of the nasal mucosa (the mucosa loses its elasticity, strength, may be damaged from slightimpact);
- very hot and dry air in the room (as a result, the mucous membrane dries up);
- inhalation of tobacco smoke, dust, small particles of animal hair (also irritating to the nasal mucosa);
- formation of mucus and fragility of blood vessels on the septum (may be a consequence of irritating factors or caused by various he alth disorders);
- pressure drops, such as when climbing mountains or flying in an airplane;
- a high temperature in a child can also cause bleeding;
- hormonal changes that occur during adolescence;
- too much physical tension or strong emotional experiences, stress (provoke an increase in blood pressure).
Often there is bleeding due to trauma (and it can be of a different nature and strength) or a foreign body entering the nose. In the first case, both nose picking and bone fracture can provoke the appearance of blood. Even if the child blows his nose too hard, hemorrhage may open. As for the second option, children, and especially small ones, can stick some object up their nose, which is not always immediately known to parents. The discharge in this case appears with pus, has an unpleasant odor.
These are the most common causes of bleeding and are relatively easy to fix. But frequent nosebleeds in a child can also occur due to other moredangerous conditions, he alth disorders. In this case, you will definitely need to consult a doctor so that the specialist makes an accurate diagnosis and prescribes the appropriate treatment. The following reasons may lead to frequent nosebleeds in children:
- Various blood diseases. For example, hemophilia is a congenital disease characterized by the complete absence or significant impairment of blood clotting.
- Increased vascular permeability as a result of an inflammatory process (for example, with vasculitis) or with serious illnesses (measles, influenza, and so on), some hereditary diseases, vitamin C hypovitaminosis (lack of ascorbic acid).
- Chronic pathologies that disrupt the liver (cirrhosis or hepatitis, for example).
- Chronic diseases of the paranasal sinuses or nasal cavity, which are of an inflammatory nature.
- Various conditions that are accompanied by an increase in blood pressure. It can be physical exertion, renal hypertension, sunstroke or general overheating of the body).
- Changes in mucosal structure caused by various infections (such as syphilis, diphtheria or tuberculosis) or chronic rhinitis.
- Different kinds of benign and malignant tumors in the nasal cavity. For children, as a rule, neoplasms that are benign in nature are characteristic.
In addition, the causes of nosebleeds in children can be determined by the anatomical features of the structure of the nasal septum, anomalies in the development of the vascular system of the nose, curvaturenasal septum. In the latter case, breathing is also difficult.
Opinion of Dr. Evgeny Olegovich Komarovsky
A pediatrician of the highest category and host of the Doctor Komarovsky School program, whose opinion many parents trust, also spoke about nosebleeds in children. Komarovsky notes that the tendency to bleeding from the nose is often determined precisely by the anatomical features of the structure of the mucous membranes, in particular, the depth of the location of the vessels and their diameter.
Blood can come from both the front and back of the nose. According to Evgeny Olegovich, the vast majority of manifestations of this symptom in childhood are caused by damage to a vessel located in the nasal septum. This is bleeding from the front of the nose. Options when blood comes from the posterior sections are relatively rare in childhood, but always dangerous. In this case, Komarovsky calls the cause of nosebleeds in children the manifestation of serious diseases of the internal organs, which are accompanied by disorders of the blood coagulation system and vascular damage.
Here's the most handy symptom to help parents determine if nosebleeds are dangerous: Posterior bleeding is almost always from both nostrils, anterior bleeding is usually from one. Frequent nosebleeds in a child is definitely a reason to contact a specialist as soon as possible for examination, diagnosis and adequate treatment.
First Aid
Howstop a nosebleed in a child? It is necessary to take actions that are aimed at stopping the symptom as soon as possible. Help with nosebleeds in a child should be provided immediately. Here is a brief algorithm of actions for parents:
- Reassure the child, because the stress of seeing blood can cause high blood pressure and heart rate, which will only increase bleeding. The child and others need to be convinced that nothing terrible is happening, there is no danger to life, and the bleeding itself will soon stop. Parents need to stay calm and not panic.
- Seat the child so that the back is straight, the head is slightly lowered down, and the body is slightly tilted forward. Then gently squeeze the wings of the baby's nose with your fingertips, in other words, squeeze the nose. Stay in this position for at least ten minutes. Do not remove your fingers every thirty to fifty seconds, checking whether the blood is flowing or has already stopped.
- During these ten minutes, while the parent holds the child's nose pinched, you can put something cold on the bridge of the nose. Suitable, for example, an ice cube, a spoon, a coin or frozen vegetables. It is helpful to give your child something cold to drink or eat (e.g. ice cream, a glass of ice water through a straw), as the cold in the mouth will effectively stop nosebleeds.
Adult Mistakes in Helping
How to stop a nosebleed in a child? Practice shows that most parents, faced with such a problem, get lost and commiterrors. Here are some mistakes adults can make when helping children with nosebleeds:
- You can't tilt your head back. In this case, the blood will not flow out of the nose, but will flow inward along the back wall of the nasopharynx. This makes it impossible to determine how intense the bleeding is, whether it has stopped or not, and the baby can suffocate if there is too much blood.
- No need to stuff cotton, the corner of a handkerchief, a tampon or other "plugs" into your nose. So, instead of flowing out, the blood will soak the cotton wool, thicken, gradually dry up to the nose along with the “plug”. Once the parents remove the cotton, the bleeding may start again.
- You can not put the child in the prone position. With severe bleeding, vomiting may begin with an admixture of blood, which in this position almost always leads to the fact that the child chokes. It is best, as already mentioned above, to put the child on a chair or slightly tilt his body forward.
- With severe nosebleeds, do not provoke the child to talk or move. In most cases, this will only exacerbate the problem. But of course, it is necessary to calm the baby during first aid.
When you need to call a doctor
Nosebleeds in children are usually not too serious and quickly correctable problem, but there are situations when qualified medical care is vital. This is true for the following circumstances:
- The bleeding didn't stop for twenty minutes. It is necessary to repeat the procedure for providing assistance (for another ten minutes, pinch the wings of the child's nose with your fingers). If after that the blood from the nose is still flowing, then it is urgent to call the doctors.
- Intensive bleeding from the nose, which comes from both nostrils at once. As a rule, this is caused by more serious causes than minor mechanical damage to the mucosa.
- Nosebleed is aggravated by any other bleeding. If at the same time there is blood from the ear, for example, then you need to urgently call the doctors.
- Nosebleeds are regular. If the problem recurs every day, once every two or three days, once a week and the like, then it is imperative to show the child to a pediatrician.
With such nosebleeds in children, the need to visit a doctor is fully justified, since this symptom may indicate some kind of dangerous disease, and not just be the result of a burst vessel.
Also, an ambulance should be called if the child has blood mixed with a clear liquid (especially after a head injury) or foams, he loses consciousness, vomiting appears mixed with blood. The help of qualified doctors is necessary for bleeding in children with diabetes mellitus, hemophilia or other blood diseases, as well as if the problem arose while taking Ibuprofen, Indomethacin, Aspirin, Heparin and other similar drugs that worsen clotting properties blood.
Coagulation of burstvessels by laser or nitrogen
Nosebleeds in children in the hospital are stopped by coagulation. Cauterization of a burst vessel with a laser, electricity or liquid nitrogen is carried out if the blood comes from the front of the nose. Indications for coagulation (electrocoagulation) are frequent bleeding, ineffectiveness of attempts to stop the blood in another way, very heavy bleeding, and anemia due to relapses.
Treatment of bleeding from the back of the nose
Treatment of nosebleeds in children is also carried out with the use of hemostatic drugs. These methods are used if the blood comes from the back of the nose. Vikasol or sodium etamsylate are prescribed. If the blood loss is profuse, then solutions are administered intravenously, and, if necessary, donor blood components are transfused.
If there is a foreign object in the nose, then it is pulled out. In rare cases, it is necessary to use surgical methods, such as ligation or embolization of a bleeding vessel. The hospital also conducts a full medical examination to determine the cause of the bleeding.
Therapy and prevention of frequent nosebleeds
The causes and treatment of nosebleeds in children are interrelated. So, if the problem occurs frequently, doctors may suspect a disease associated with impaired blood clotting processes. In this case, special treatment will be needed for the cause of the bleeding.
If the blood comes from behindmechanical damage, that is, trauma or a foreign body entering the nose, then you need to act according to the situation. Much depends on the severity of the injury (for example, a head injury that causes nosebleeds usually requires additional treatment). In case of damage caused by a slight mechanical impact, there is no need to prescribe hemostatic drugs.
For therapeutic and prophylactic purposes, calcium preparations, retinol, also known as vitamin A (used as an oily solution for instillation into the nose), "Ascorutin" are prescribed. For children with nosebleeds, the dosage of Ascorutin is shown as follows: one tablet three times a day. The course of therapy is ten days. Ascorutin is not prescribed for children with nosebleeds with the following diagnoses:
- diabetes;
- kidney failure;
- urolithiasis;
- increased blood clotting;
- individual sensitivity to drug components;
- thrombophlebitis;
- fructose intolerance.
Some traditional medicine recipes
There are several alternative medicine recipes that can help reduce the incidence of nosebleeds in a child:
- drop the juice of yarrow leaves into the nose;
- take half a glass of bedstraw decoction three times a day, the decoction is prepared from two tablespoons of dry grass, pour half a liter of water, boil for ten minutes, and then insist for an hour;
- acceptone tablespoon of viburnum bark decoction three times a day, before meals, for cooking, pour four tablespoons of crushed bark with one glass of water and boil for thirty minutes, and then strain and dilute with boiled water to the initial amount of liquid;
- drink a tablespoon of nettle decoction four times a day, the decoction is prepared from a tablespoon of nettle leaves, which you need to pour a glass of water, boil for ten minutes, then cool and strain.
How to prevent nosebleeds
To prevent the problem from reoccurring, you need to walk more often with the child in the fresh air, play outdoor games, saturate the diet with fresh vegetables and fruits according to the season, and additionally give the baby vitamins prescribed by the doctor. Humidify and ventilate the room in which the child is constantly located as often as possible.
