Children's Hospital Colorado

Nosebleed

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • Bleeding from 1 or both nostrils
  • Not caused by an injury

Causes of Nosebleeds

Nosebleeds are common because of the rich blood supply of the nose. Common causes include:

  • Spontaneous Nosebleed. Most nosebleeds start up without a known cause.
  • Rubbing. Rubbing or picking the nose is the most common known cause. It's hard to not touch or rub the nose.
  • Blowing. Blowing the nose too hard can cause a nose bleed.
  • Suctioning. Suctioning the nose can sometimes cause bleeding. This can happen if the suction tip is put in too far.
  • Sinus Infections. The main symptoms are lots of dry snot and a blocked nose. This leads to extra nose blowing and picking. The sinus infection is more often viral than bacterial.
  • Nose Allergies. The main symptom is a very itchy nose. This leads to extra rubbing and blowing.
  • Dry Air. Dryness of the nasal lining makes it more likely to bleed. In the winter, forced air heating often can dry out the nose.
  • Allergy Medicines. These help the nasal symptoms, but also dry out the nose.
  • Ibuprofen and Aspirin. These medicines increase the bleeding tendency. Aspirin is not used in children.
  • Bleeding Disorder (Serious). This means the blood platelets or clotting factors are missing or not working right. A bleeding disorder should be suspected if the nosebleed can't be stopped. Excessive bleeding from the gums or with minor cuts is also a clue. Bleeding disorders are a rare cause of frequent nosebleeds.

Call 911 Now

  • Passed out (fainted) or too weak to stand
  • You think your child has a life-threatening emergency

Go to ER Now

  • Bleeding a lot after 20 minutes of squeezing the nose correctly

Call Doctor or Seek Care Now

  • Nosebleed that won't stop after 10 minutes of squeezing the nose correctly
  • Large amount of blood has been lost
  • New skin bruises or bleeding gums not caused by an injury also present
  • High-risk child (such as with low platelets or other bleeding disorder)
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Age less than 1 year old
  • New onset nosebleeds happen 3 or more times in a week
  • Hard-to-stop nosebleeds are a frequent problem
  • Easy bleeding is present in other family members
  • You have other questions or concerns

Self Care at Home

  • Mild nosebleed

Care Advice for Nosebleed

  1. What You Should Know About Nosebleeds:
    • Nosebleeds are common.
    • You should be able to stop the bleeding if you use the correct technique.
    • Here is some care advice that should help.
  2. Squeeze the Lower Nose:
    • Gently squeeze the soft parts of the lower nose together. Gently press them against the center wall for 10 minutes. This puts constant pressure on the bleeding point.
    • Use the thumb and index finger in a pinching manner.
    • If the bleeding continues, move your point of pressure.
    • Have your child sit up and breathe through the mouth during this procedure.
    • If rebleeds, use the same technique again.
  3. Put Gauze Into the Nose:
    • If pressure alone fails, use a piece of gauze. Wet it with a few drops of water. Another option is to put a little petroleum jelly (such as Vaseline) on it.
    • Insert the wet gauze into the side that is bleeding. Press again for 10 minutes. Reason it works: the gauze puts more pressure on the bleeding spot.
    • Special nose drops: if your child has lots of nose bleeds, buy some decongestant nose drops. An example is Afrin. No prescription is needed. Put 3 drops on the gauze and press. The nose drops also shrink the blood vessels in the nose.
    • Caution: don't use decongestant nose drops if your child is under 1 year of age.
    • If you don't have gauze, use a piece of paper towel.
    • Repeat the process of gently squeezing the lower soft parts of the nose. Do this for 10 minutes.
  4. Prevent Recurrent Nosebleeds:
    • If the air in your home is dry, use a humidifier to keep the nose from drying out.
    • For nose blowing, blow gently.
    • For nose suctioning, don't put the suction tip very far inside. Also, move it gently.
    • Do not use aspirin and ibuprofen. Reason: Increases bleeding tendency.
    • Bleeding areas in the front of the nose sometimes develop a scab. It may heal slowly and re-bleed. If that happens to your child, try this tip. Apply a small amount of petroleum jelly (Vaseline) to the spot. Repeat twice a day. Do not use for more than 2 days.
  5. What to Expect:
    • Over 99% of nosebleeds will stop if you press on the right spot.
    • It may take 10 minutes of direct pressure.
    • After swallowing blood from a nosebleed, your child may vomit a little blood.
    • Your child may also pass a dark stool tomorrow from swallowed blood.
  6. Call Your Doctor If:
    • Can't stop bleeding with 10 minutes of direct pressure done correctly
    • You think your child needs to be seen
    • Your child becomes worse

Care Advice for Nosebleed

First Aid - Nosebleed
  • Sit up and lean forward. This will keep the blood from running down the back of the throat.
  • Apply Pressure. Gently squeeze the lower soft parts of the nose against the center wall for 10-15 minutes. Use your thumb and your index finger in a pinching manner.
  • If the bleeding continues, move your point of pressure and repeat again for another 10-15 minutes.

Special Notes: The goal is to apply continuous pressure to the bleeding point inside the nose.

Disclaimer

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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Copyright 2000-2018. Schmitt Pediatric Guidelines LLC.

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