Causes of nosebleeds in children. Nosebleeds in a child: causes and treatment

If blood flows from the nose of a child, the reasons can be very different, ranging from simple mechanical damage to the mucosa to severe hematological diseases. If you have this symptom, you should contact your pediatrician and undergo an examination.

Not everyone knows why a child is bleeding from the nose and why it is dangerous. Children of all ages face similar problems.

Epistaxis is a pathological condition characterized by the outflow of blood due to damage to blood vessels. In childhood, this occurs 4-5 times more often than in adults. There are the following causes of bleeding from the nose:

viral diseases (flu, measles, scarlet fever),
head tumors,
injury,
the bad habit of picking your nose with your fingers,
frequent insertion of tampons,
regular use of vasoconstrictor drugs,
hemophilia,
vasculitis,
systemic lupus erythematosus,
lack of platelets
blood clotting disorder
deviated septum of the nose,
breathing dry air
benign and malignant tumors,
hypovitaminosis,
hormonal changes during puberty,
hypertension,
increased intracranial pressure,
trauma during childbirth
congenital and acquired malformations,
gastrointestinal bleeding,
exposure to ionizing radiation,
severe atherosclerosis,
rise to great heights
pathology of the kidneys and liver,
heart disease.

Risk factors for developing this condition include poor nutrition, stress, exercise, changes in temperature and atmospheric pressure.

If a child's nose bleeds, prolonged exposure to the sun may be the cause. Dangerous and physical overload.

The state of blood vessels in children largely depends on external factors and the state of the body as a whole. Their fragility increases with a lack of any substances, with toxic effects or injury.

Mechanical damage to the nose

Children 10 years and older lead a very active lifestyle. At this age, trauma is the most common cause of bleeding. They are household, street, road.

Bleeding occurs as a result of a bruised nose, a fall, or a strong blow. This is possible under the following circumstances:

fights,
falling while running
falling from a height,
cycling.

Possible damage to blood vessels as a result of medical manipulations (catheterization, endoscopic examination, removal of polyps, sinus puncture). Injury often occurs when foreign objects hit. Children aged 4 years and younger like to put them in their noses. The most common injury is a bruise. It does not fracture.

Against the background of a bruise, the formation of a hematoma is possible. This is a cavity filled with blood.

Bleeding from the nose in children with a bruise is not the only symptom. There may be severe pain. Often, breathing is disturbed. With a fracture of the bones, the curvature of the nose in a child is visually determined. Isolated trauma is rare. Most often, the brain also suffers.

The reason for the lack of vitamins

A kid of any age needs good nutrition. The risk of bleeding increases with a lack of vitamins P and C in the body. This condition is called hypovitaminosis. The state of blood vessels depends on these substances. Vitamin P (rutin) is a flavonoid. It has the ability to reduce the permeability of blood vessels and strengthen their wall.

It is found in citrus fruits, rose hips, walnuts, cabbage, currants, chokeberry, buckwheat, lettuce, tomatoes. If a child rarely consumes these products, then a deficiency of the routine develops.

Hypovitaminosis can also be due to other causes (worm infestation, intoxication, antibiotics). Lack of routine is manifested by nosebleeds, hemorrhages, acne. Bruises often appear on the body of children. Often there is bleeding from the nose and gums.

Ascorbic acid is no less useful. The lack of this vitamin is due to a deficiency in the diet of fresh fruits, berries and vegetables. Hypovitaminosis is manifested by increased fragility of mainly small vessels (capillaries). Nosebleeds are observed in severe cases. Depending on age, the daily requirement for vitamin C is 30-90 mg.

Bleeding with high intracranial pressure

Rupture of small vessels in the nose is possible against the background of hypertension. Increased intracranial pressure is a common cause of bleeding in children. The following etiological factors are of greatest importance:

the inability of young children to blow their nose correctly,
the presence of neoplasms (hematomas, tumors),
abscesses
aneurysm,
edema on the background of encephalitis,
hepatic encephalopathy,
brain toxicity,
meningitis,
increased blood flow to the brain
hydrocephalus,
brain compression,
microcephaly,
congenital malformations,
birth trauma,
fetal infection.

Hypertension is manifested by periodic bleeding from the nose, headache, visual and oculomotor disorders, nausea, and vomiting.

Both a baby and an older child can get sick.

Most often, bleeding occurs against the background of congenital pathology. In chronic hypertension, periodic crises are observed, in which the pressure rises sharply.

Bleeding in chronic atrophic rhinitis

In children 11 years of age and older, the cause may lie in diseases of the nasal cavity. These include chronic atrophic rhinitis.

Teenagers are more commonly affected. Ozena is a type of atrophic rhinitis. In girls, this disease is detected much more often.

In children, this pathology is much less common than in adults.

From what rhinitis develops, only doctors know. The following causes of nosebleeds and atrophy of the nasal mucosa in children are distinguished:

injury,
severe infections,
diseases of the stomach, intestines and biliary tract,
surgical interventions,
performing radiation therapy,
genetic predisposition,
living in a dry, hot climate,
frequent colds,
uncontrolled use of nasal drops.

With a simple form of rhinitis, the symptoms are specific. These include intermittent bleeding, runny nose, nasal congestion, difficulty breathing, pale skin, child breathing through the mouth, crusting, itching in the nose, decreased sense of smell.

Rhinitis is focal and diffuse. The nose may bleed when you blow your nose. The reasons are thinning of the mucosa, its dryness and increased fragility of capillaries. The blood vessels in the nose are shallow.

Bleeding on the background of the tumor

There are serious diseases that lead to damage to blood vessels. The causes of nosebleeds in children include tumors. These can be angiofibromas and hemangiomas. This pathology often requires surgical treatment, otherwise bleeding can become permanent and lead to anemia. In children aged 5-12 years, angiomas are a common pathology.

These tumors account for up to 80% of all cases of congenital neoplasms. They form from dilated blood vessels. This pathology can be detected in a newborn. Symptoms are determined by the size of the neoplasm, its type and the age of the child. The tumor tends to grow.

If bleeding occurs, you should immediately go to the doctor.

Nosebleeds in children indicate the development of complications. This symptom is associated with the formation of ulcerative defects on the mucosa, their damage and infection. In case of injury to hemangiomas, emergency care may be needed.

Bleeding in hemophilia

In children aged 3-9 years and older, hemorrhages are often caused by diathesis. This is a group of pathological conditions caused by impaired hemostasis. In sick children, there is a tendency to constant hemorrhages and bleeding. There are about 300 diatheses.

The most common are those associated with leukemia, hemophilia, von Willebrand disease, disseminated intravascular coagulation, low platelets, and vascular defects.

Bleeding from the nose in childhood is a symptom of hemophilia. This is a hereditary disease characterized by a deficiency of a coagulation factor. The first symptoms appear in childhood.

The hereditary form of hemophilia develops only in boys. The acquired form of hemophilia, caused by gene mutation, is much less common. The age of children and the symptoms of the disease are interrelated.

Bleeding is caused by a violation of the formation of thromboplastin. This leads to a significant increase in clotting time. Massive blood loss can be fatal. It is known that a one-year-old child can already walk. This causes nosebleeds. At an earlier age, this symptom is absent.

In children aged 5-7 years, the manifestations of hemophilia are more pronounced. This disease is characterized by the following symptoms:

prolonged nosebleeds,
hematomas,
hemarthrosis (accumulation of blood in the joint cavity),
hematuria,
gastrointestinal bleeding.

The disease causes disability. Often, soft tissues are also involved in the process. On visual examination, multiple bruises are visible on the skin. Sick children twelve years of age and older need lifelong replacement medications. There is no cure for hemophilia completely.

Leukemia as a cause of bleeding

In pediatric practice, a disease such as leukemia is common. This is blood cancer. The disease is detected among children and adults of different ages. The child may be one year old or ten years old.

This is a systemic disease that requires chemotherapy. The reason for the development of leukemia in children and bleeding is a change in the structure of chromosomes.

With this pathology, immature blood cells are formed in the bone marrow, which are not able to perform their functions. Girls get sick 1.5 times more often than boys.

This pathology is often detected in children with Down's disease and Klinefelter's syndrome. The acute form of leukemia is manifested by the following symptoms:

bleeding (nasal, stomach, intestinal, uterine),
signs of hypoxia of the body,
weakness
malaise,
enlargement of the liver, spleen and lymph nodes,
weight loss,
joint pain,
fever
petechiae on the body.

DIC and anemia often develop. In leukemia, hemolysis (destruction of red blood cells) occurs. The outflow of blood in cancer is possible from one nostril or from both at once. The development of hemorrhagic syndrome is based on hyperplasia of vascular cells, an increase in their permeability and impaired functioning of mast cells.

Bleeding in Werlhof disease

With nosebleeds in children, the cause may lie in thrombocytopenic purpura. This is a type of hemorrhagic diathesis.

This pathology is otherwise called Werlhof's disease. Its development is based on a lack of platelets. The first signs of the disease are detected in children of early and preschool age. The baby may look healthy after birth. Diathesis appears later.

There are the following reasons for the development of this pathology:

taking medications (mercury drugs, hormones),
immunization,
viral diseases,
bacterial infections,
irradiation.

Children at the age of four have a wide variety of symptoms. Bleeding from the gums and nose are the most common signs of Werlhof's disease. They are very intense. Nosebleeds are combined with hematuria, impaired stool, vomiting, hemoptysis. Large blood loss leads to acute post-hemorrhagic iron deficiency anemia.

Altitude sickness and bleeding

Children are very sensitive to lack of oxygen. Nosebleeds are a common symptom of altitude sickness. This is a condition associated with oxygen starvation. The reason is being at a high altitude above sea level.

The higher, the lower the partial pressure of oxygen. Often this condition is observed in adolescents who are fond of hiking, flying on airplanes and hot air balloons.

Many older children over the age of 12 go camping with their parents. When climbing to a height of more than 2 km, symptoms of altitude sickness appear. One of them is nosebleeds. Its occurrence is due to the following changes in the body:

hypoxia
increased pressure in blood vessels,
venous stasis,
fluid retention,
increased capillary permeability,
a decrease in the osmotic pressure of the blood.

With mild mountain sickness, nosebleeds do not occur. With an average - they appear. Severe altitude sickness is characterized by severe bleeding from the nose, mouth, stomach, and lungs. The condition of these children is unsatisfactory. Along with bleeding, symptoms such as shortness of breath, palpitations, fatigue, weakness, unproductive cough, cyanosis of the skin, abdominal pain, flatulence, chills, and fever are observed.

When these complaints appear, you should consult a doctor. If the bleeding does not stop or occurs repeatedly, then a comprehensive examination is required. Blood clotting and the condition of vital organs are assessed.

Thus, nosebleeds occur not only in adults, but also in children. It may indicate a serious pathology.

Nosebleeds in children always scare both parents and the kids themselves. So, nosebleeds can be the result of both a simple wound on the nasal mucosa, and indicate more serious health problems.

What happened to the child, what is the cause of bleeding, how to help? Many are lost, not knowing what to do, how to provide first aid. To properly behave in such a situation, read the proposed article.

Types of nosebleeds

There are two types of nosebleeds: anterior and posterior. The first type (anterior) is the most common and accounts for about 90% of all nosebleeds. It is characterized by a calm flow of blood when the vessels in the front of the nose are damaged. The second type (posterior) is much less common - in 10% of all cases. Such bleeding occurs due to damage to larger and deeper vessels, while the blood drains intensively along the back of the pharynx. It is more difficult to stop, it is more abundant, and therefore it is advisable to urgently seek qualified medical help without trying to cope with it yourself.

Not far from the nasal entrance, in the anterior part of the nasal septum, there is a small Kisselbach zone (the size of a penny coin). It is rich in blood vessels, its mucosa is looser and thinner than in other areas. Therefore, it is very easy to break the membrane and cause nosebleeds in this particular area of the vascular plexus. This is what happens in most cases.

Causes of nosebleeds

Most often, nosebleeds in children occur for local reasons - as a result of an injury to a blood vessel or an anomaly in its development.

The direct cause of any bleeding is one - rupture of a blood vessel. But what provoked him, you need to figure it out as soon as the child is given first aid.

Common causes can occur under various conditions:

The fragility of the vascular walls, when the vessels are easily damaged as a result of the slightest stress in them:

infectious diseases occurring against the background of high temperature (, measles, rubella, whooping cough, meningococcal, etc.);
vasculitis (non-infectious inflammation of the walls of blood vessels);
Osler-Rendu-Weber disease (hereditary pathology, a type of hemorrhagic diathesis, characterized by underdevelopment of the walls of blood vessels);
lack of vitamins, especially ascorbic acid and vitamin K, as well as calcium.

An increase in blood pressure at which a rupture of the capillary wall occurs:

physical and emotional overload;
adrenal tumors;
emphysema and pneumosclerosis;
chronic kidney disease - glomerulonephritis and;
aortic and mitral stenosis ();
some other congenital heart defects;

Blood diseases:

disorders in the mechanism of blood clotting, for example, with hemophilia, coagulopathy, hemorrhagic diathesis;
leukemia or aplastic anemia;
Werlhof's disease (thrombocytopenic purpura) - a decrease in the number of platelets in the blood;
and other chronic diseases that affect blood clotting;
agranulocytosis (decrease in the number or complete absence of leukocytes in the blood).

Other reasons:

migraines and nervous disorders;
severe coughing and sneezing (contribute to a sharp increase in pressure in the vessels of the nose, because of which they can burst);
systemic lupus erythematosus (hereditary disease resulting from);
changes in the hormonal background during adolescence in girls, during which there is an increased production of the sex hormones estrogen and progesterone;
dry air in the room, when the nasal mucosa dries up, atrophies, and the vessels become brittle;
sun or heat stroke (they are usually accompanied by tinnitus, weakness and dizziness);
frequent tamponade of the nasal cavity, as a result of which atrophy of the mucous membrane develops, and as a result, bleeding begins;
taking certain medications - vasoconstrictor nasal drops, antihistamines, corticosteroids, Heparin, Aspirin.

Rare causes of nosebleeds in children include:

exposure to radiation;
chemical, thermal and electrical burns of the nasal mucosa;
chronic intoxication of the body with harmful vapors and gases contained in aerosols and various chemicals;
changes in barometric pressure, such as when climbing or swimming at depth.

Sometimes nosebleeds are mistaken for bleeding from the esophagus, stomach, and lungs, when blood leaks out through the nose and mouth.

Symptoms

Nosebleeds practically do not require diagnosis, unlike the causes that caused it.

In addition to the signs of the underlying disease, several symptoms can be distinguished:

flowing from the nose of pure scarlet blood;
ringing or noise in the ears;
dizziness;
flashing flies before the eyes;
shortness of breath, rapid breathing;
heartbeat;
discomfort in the nose;
headache;
thirst;
general weakness.

When bleeding from the back of the nose, hemoptysis and vomiting of scarlet blood may occur.

Nosebleeds are usually one-sided, but in severe cases, the blood can fill the entire nostril and pass into the other. In this case, it will flow from both nostrils, even if the vessel is damaged only on one side.

Diagnostics

Only a pediatric ENT doctor can determine the type of bleeding using rhinoscopy and pharyngoscopy. After stopping the bleeding, you should begin to search for the causes, that is, fully examine the child:

take blood tests;
consult a pediatrician and pediatric specialists (hematologist, endocrinologist, cardiologist, immunologist, oncologist).

Complications

With heavy nosebleeds, hemorrhagic shock may develop:

a sharp decrease in blood pressure as a result of large blood loss;
confusion or loss of consciousness;
tachycardia;
severe pallor of the skin;
weak thready pulse.

For an objective assessment of the child's condition after blood loss, it is necessary to do a general blood test and a coagulogram.

Frequent nosebleeds can lead to serious consequences:

general depletion of the body;
development of anemia;
decrease in immunity.

Chronic oxygen starvation in the case of nosebleeds leads to disruption of the activity of various organs, as well as to the development of irreversible pathological changes in their structure.

If such health problems are ignored, death is possible.

Helping a child with a nosebleed

Do not tilt your child's head back. Against! It is necessary to slightly tilt his torso forward and firmly press the wings of the nose to the nasal septum with your fingers.

Anterior nosebleeds stop almost immediately and almost spontaneously. But still, some manipulations are required:

calm the child, seat him on a chair, and pick up the smallest ones;
unfasten clothes, try to make the child breathe in through the nose, and exhale through the mouth;
feet should be warm;
tilt your head slightly forward and pinch your nostrils with your fingers;
throw back your head, but at the same time be sure to put a cold on the bridge of your nose and insert a swab into your nose;
put cold on the back of the head;
make a small tampon from cotton wool or bandage, moisten it in a 3% hydrogen peroxide solution or in vasoconstrictor drops and insert it into the nostril;
if there is no hydrogen peroxide, drip vasoconstrictor drops into the nose - Galazolin, Naphthyzin, Rinazolin or 0.1% adrenaline solution;
if bleeding continues, then after 10-15 minutes you need to call an ambulance.

As soon as the bleeding stops, the tampon cannot be pulled out sharply: this way you can damage the clot, and the blood will flow again. It is best to moisten it with hydrogen peroxide, and then remove it.

Then, twice a day, lubricate the nasal mucosa with petroleum jelly (or Neomycin, Bacitracin ointment) to prevent it from drying out again and promote better healing, which can last from 1 to 5 weeks.

With dry air in the apartment, especially during the heating season, it is recommended that the child instill in the nose products based on sea water - Salin or Aquamaris.

After stopping the bleeding of the child, it is necessary to show the ENT doctor to prevent recurrence. He will examine the baby, if necessary, he will cauterize the bleeding area, and if necessary, he will send him for a full examination to find out the reasons.

When bleeding, you can not:

blow your nose, this will displace the clot that forms, and the blood will flow again;
tilt your head back, as blood will drain down the back of the throat, enter the stomach or block the airways; in the first case, vomiting may occur, and in the second, suffocation;
if the cause of bleeding is a foreign body, it cannot be removed on its own, as it can move and cause suffocation.

Indications for calling an ambulance:

bleeding does not stop within 15-20 minutes;
there was a head injury, after which blood from the nose goes along with a clear liquid (suspicion of a fracture of the base of the skull);
intense bleeding, blood flows out in a stream, a clot does not form;
there is hemoptysis (back bleeding) or vomiting of blood (bleeding from the esophagus);
frothy blood (pulmonary bleeding);
in addition to bleeding, there is vomiting of the color of coffee grounds, which indicates gastric bleeding;
a child (teenager) often has high blood pressure;
a child whose nose bleeds is suffering from diabetes;
the baby had a faint;
a small patient receives drugs that reduce blood clotting - Aspirin, Indomethacin, Ibuprofen, Heparin, etc .;
the child is sick with hemophilia or other diseases with a violation of the mechanism of blood clotting.

Medical assistance

To stop intense nosebleeds, an ENT doctor can take the following measures:

anterior or posterior tamponade impregnated with a 1% solution of feracryl, preserved amnion, epsilon-aminocaproic acid;
remove a foreign body or polyps if they appear and cause nosebleeds;
the introduction of a swab with trichloroacetic acid or vagotil, which cauterize the vessels, thus stopping the bleeding;
coagulation (cauterization) of the bleeding area of the mucosa in one of the following ways: laser, ultrasound, electric current, liquid nitrogen, silver nitrate, chromic acid;
use of a hemostatic sponge in the nasal cavity;
with abundant blood loss - transfusion of donor blood, fresh frozen plasma, intravenous administration of rheopolyglucin, hemodez and aminocaproic acid;
if the measures provided are ineffective, surgical intervention is indicated - ligation or embolization (blockage) of large vessels that supply blood to the problem area of the nasal mucosa;
endoscopic cryodestruction;
the introduction of sclerosing drugs, an oil solution of vitamin A;
the appointment of drugs that increase blood clotting - calcium chloride, Vikasol, ascorbic acid, calcium gluconate.

In case of intensive bleeding or massive blood loss, hospitalization of the child in the ENT department is mandatory.

The most common spontaneous bleeding is nosebleeds. They are often observed in children of different age groups. The nature and frequency of nosebleeds does not depend on the sex of the child. According to statistics, nosebleeds are the cause of hospitalization in the ENT hospital in 5-10% of all cases.

Nosebleeds can occur suddenly, sometimes even during sleep. It can be one- and two-sided, with different duration and intensity: blood can flow slowly or in a jet. In some cases, bleeding may be short-lived and stop spontaneously.

Sources of nosebleeds

Children have narrow nasal passages and easily vulnerable tender mucous membrane in the nasal cavities. The blood supply is provided by branches of the carotid arteries, which are intertwined in the mucosa.

One of these vascular plexuses (Kisselbach's zone) is formed in the anterior sections on both sides of the nasal septum, where the mucosa is especially thin. It is it, located superficially, that is easily injured and is the source of nosebleeds in 90%. Therefore, it is called the bleeding zone.

This bleeding is called "anterior" nosebleeds. It is usually not intense, can stop on its own, usually does not pose a threat to life. But still, frequent bleeding can cause anemia, which is not indifferent to a growing organism.

Bleeding can also occur from a deeper located department (), from larger vessels. It can be very profuse and does not stop on its own. It rarely develops in children.

The intensity of blood loss increases quickly enough and can become life-threatening. A child can lose a liter of blood or more. To stop the loss of blood is possible only with special medical manipulations.

The reasons

In some cases, nasal trauma leads to nosebleeds.

Nosebleeds may be associated with:

with damage to the integrity of the vessel wall due to or increased permeability;
with pathology in the blood coagulation system.

Bleeding can occur spontaneously or be provoked by an external action. Causes of nosebleeds are divided into general and local.

To local reasons relate:

Injuries of a different nature and strength: from damage to blood vessels with the fingers of a child when picking his nose to.
: with direct damage to the mucosa and blood vessels or as a result of an inflammatory process with a long stay in the nose of a foreign body. More often this is typical for children at a younger age, who are able to put all kinds of objects up their noses, which is far from always becoming known to parents. Bloody discharge is combined with purulent discharge, which has an unpleasant odor.
Neoplasms in the nasal cavity (in children more often).
- characterized not only by bleeding, but also.
Anomalies in the development of blood vessels in the nasal cavities - local expansion of venous or arterial vessels.
Structural changes in the mucosa with and some infections (diphtheria, whooping cough,).
Damage to the mucosa and blood vessels during drying due to dry air in residential premises: the mucosa fuses with the vascular wall and breaks when you blow your nose or sneeze, damaging the fused vessel.
Medical operations and procedures ( , ).

General reasons There may be various diseases and conditions that lead to violations of blood coagulation processes or increased permeability of the walls of blood vessels:

Diseases of the blood and coagulation system (hemophilia - a genetic disease consisting in the absence of a blood coagulation factor; other coagulopathy).
Vasculitis (inflammation of blood vessels, accompanied by increased permeability of their walls), characteristic of some severe infections (flu, measles, etc.).
Lack of vitamins C or K, calcium deficiency, increasing vascular permeability.
Liver pathology in the stage of decompensation (chronic hepatitis, cirrhosis).
Conditions and diseases that occur with high blood pressure: kidney pathology, hypertension, significant physical exertion, overheating, sunstroke.
High fever.
Significant changes in atmospheric pressure (when flying in an airplane, when climbing mountains).
Hormonal changes in adolescents.

Emerging bleeding from the nose can be an early manifestation of serious diseases and have a recurrent course.

In any case, even if it was possible to stop the bleeding at home, the child must be shown to a pediatric ENT doctor to determine the cause of the pathology. Sometimes you may need to consult doctors of other specialties (pediatrician, hematologist) and laboratory tests.

Symptoms

Blood in nosebleeds flows from the nasal passages. The amount of blood can be different - from a few drops to a stream. Part of the blood drains into the throat, and this can cause underestimation of the degree of blood loss.

When bleeding from deeply located parts of the nasal cavities, all the blood can drain to the back of the pharynx and be swallowed. Subsequent hematemesis may be the first manifestation of nosebleeds.

The general condition depends not only on the volume of blood loss, but also on the initial state of health, on the age of the child. The younger the age, the more difficult the blood loss is tolerated. A severe test for health can be the loss of blood in weakened children.

The intensity of bleeding also matters. A small amount of blood lost may not affect the child's condition at all. But an impressionable, excitable baby is able to be frightened by the sight of blood and react violently to bleeding up to fainting.

With rapid and massive blood loss, weakness, ringing in the ears, dizziness, and thirst appear. There is a growing pallor of the skin, increased heart rate. If the bleeding is not stopped, blood pressure drops, shortness of breath appears, loss of consciousness occurs as a result of a sharp oxygen starvation of the brain tissues - hemorrhagic shock develops.

In some cases, when blood is released from the nose, the source of bleeding is another organ - the respiratory organs (bronchi or lungs) or digestion (esophagus, stomach). But with bleeding from the bronchi or lungs, it is noted, and the blood has a scarlet color and foams. With gastric bleeding, the blood is dark, like coffee grounds.

First aid

You should not tilt your head back. Against! It is necessary to lean forward slightly and firmly press the wings of the nose against the nasal septum with your fingers.

When nosebleeds occur:

Reassure the child, because the excitement of the sight of blood will cause an increase in heart rate and blood pressure, which will increase bleeding, increase blood loss.
Give the child a sitting or reclining position, with his head slightly lowered so that the blood does not flow into the respiratory tract or esophagus, but flows out of the nostrils. In a horizontal (lying) position, the rush of blood to the head will increase and the bleeding will increase.

Can't tilt your head back(often mistake made by adults when bleeding in children): blood will flow down the throat, the child may choke on blood or swallow it. The resulting cough or vomiting will increase bleeding. It is better to take a small child in your arms and support the head.

Substitute a container for flowing blood (to determine the volume of blood loss), explaining to the child that it is impossible to blow your nose and swallow blood.
Loosen tight clothing for better airflow. Explain to the older child the need to inhale through the nose and exhale through the mouth.
Having determined from which nasal passage blood flows, press the wing of the nose against the septum with your fingers for 5–10 minutes to form a blood clot (blood clot).
Apply cold to the nose area (a napkin or rag soaked in cold water, or pieces of ice in a plastic bag) to reduce blood flow.
If the effect is not achieved, then a sterile cotton swab should be inserted into the nasal passage, after wetting it in a 3% hydrogen peroxide solution, and pressing the wing of the nose again. You can use for wetting a 0.1% solution of adrenaline or any solution (Otrivin, Naphthyzin, Tizin, Galazolin, Sanorin).
When bleeding from the right nasal passage, you need to raise the child's right hand, and with the finger of his left hand he will press the bleeding wing of the nose, with bleeding on the left - vice versa. If two halves of the nose are bleeding, then the child will raise both hands up, and the parent will press both nostrils.

If a foreign body that caused bleeding is found in the nasal passage, then it should not be removed on its own because of the risk of displacement into the airways and subsequent. Only an ENT doctor should remove a foreign body.

When providing assistance, you need to monitor the condition of the child, control the pulse and blood pressure. If the bleeding was stopped, then with the help of a cotton swab, you need to carefully lubricate the mucosa in both nasal passages with petroleum jelly to prevent the mucosa from drying out. The child needs to drink plenty of water to replenish the volume of circulating blood.

It is also necessary to take care of humidifying the air in the room, using humidifiers for this. You can just hang wet sheets. Protect the mucosa from drying out drops of Aquamaris, Salin.

Treatment

If the measures taken did not stop the bleeding within 15 minutes, it is necessary to call an ambulance and hospitalize the child in the ENT department, where specialized medical care will be provided.

Indications for an urgent call for an ambulance are as follows:

intense bleeding and the threat of massive blood loss;
excretion of a clear liquid with blood after a head injury (possible fracture of the base of the skull);
diabetes;
hemophilia or other pathology of the blood coagulation system;
bleeding has developed against the background of the use of heparin, ibuprofen, aspirin, indomethacin or other drugs that worsen blood clotting;
resumption of bleeding after it has stopped;
bleeding on the background of high blood pressure in children;
vomiting blood or frothy blood from the nose;
loss of consciousness due to bleeding.

In a hospital with bleeding from the anterior part of the nose, it can be stopped by coagulation (cauterization) of the bleeding vessel with a laser, liquid nitrogen or electricity (electrocoagulation).

Indications for vascular coagulation:

frequent nosebleeds;
lack of effect from attempts to stop bleeding by other methods;
very profuse bleeding;
development of anemia with repeated bleeding.

In case of bleeding from the posterior part of the nasal cavity, the doctor can perform a posterior tamponade of the nasal cavity and apply hemostatic drugs (Vikasol, Etamzilat sodium). For therapeutic and prophylactic purposes, Ascorutin, calcium preparations, vitamin A are prescribed in the form of an oily solution in the nose.

With massive blood loss, intravenous solutions are administered to restore the volume of circulating blood. If necessary, donated blood components are transfused.

In the presence of a foreign body, it is removed. In rare cases, it is necessary to use surgical methods - embolization or ligation of a bleeding vessel.

The hospital conducts a complete examination of the child to clarify the cause of bleeding.

Traditional medicine recipes

Squeeze the juice from the leaves of the yarrow and drip into the nose;
2 tbsp. l. dry grass of spring bedstraw pour 0.5 liters of water, boil for 10 minutes, leave for 1 hour, take half a glass three times a day;
1 tsp geranium leaves pour 200 ml of water, bring to a boil, let it brew for 2 hours, moisten a swab and put it in the nose to stop bleeding;
chop 4 tsp. viburnum bark in 200 ml of water, boil for half an hour, strain and add boiled water to the initial volume; take 1 tbsp. l. 3 times a day before meals;
crushed dry nettle leaves (1 tablespoon) pour 200 ml of boiling water, let it brew for 10 minutes, strain, drink 1 tbsp. l. 3 times a day;
1 st. l. nettle leaves pour 200 ml of boiling water, boil for 10 minutes, cool, strain, drink 1 tbsp. l. 4 times a day.

An alternative method of treatment for nosebleeds is acupressure of biologically active points (Su Jok therapy). With a match, it is necessary to massage the pads of the thumbs on the palm of your hand, where the point of the nose is located. Then drag this point with a black tight rubber band and leave for a few minutes. Glue a pea of black pepper on this point and continue its massage. Do the same with your big toes.

Summary for parents

Nosebleeds in children are a problem for many parents. Solitary or recurrent, they require the consultation of a pediatric ENT doctor to determine the cause.

Only light bleeding can be tried to stop on its own. Parents should know the rules and be able to provide first aid for bleeding in order to correctly assess the situation and seek qualified medical help in a timely manner.

How to provide first aid to a child with nosebleeds, says the program "School of Dr. Komarovsky":

Nosebleeds often occur in childhood as a result of trauma, inflammation, and the presence of a foreign body in the organ. Parents should know how to properly provide first aid to the child and avoid dangerous complications.

Nosebleeds are not as harmless as they might seem at first glance. With abundant loss of blood, severe weakness, tinnitus, dizziness and increased heart rate appear. The child may lose consciousness, so he needs to receive emergency medical care as soon as possible.

Specialists distinguish two types of bleeding that can occur in children:

Bleeding from the anterior nasopharynx. In this pathological condition, there is damage to the vessels, which are localized directly on the nasal septum.
Bleeding from the back of the nose. In this pathological condition, the circulating fluid flows inward rather than outward. Blood from the nose appears when large vessels that are located deep in the nasal cavity are damaged.

Posterior bleeding is considered quite life-threatening for a child because it does not stop on its own, and the child needs emergency medical attention.

A common cause of bleeding is an excessive blood supply to the nasal cavity. The fact is that in children the mucous membrane of the organ is too sensitive to various external influences, so any minor damage can cause a dangerous symptom.

Frequent bleeding, albeit with a slight release of blood, requires a mandatory examination of the child. In such a situation, anemia should be ruled out and it is imperative to conduct a study of the rate of blood clotting. In the event that the speed is below the normative indicators, it is recommended to visit a hematologist. In addition, it is necessary to measure the pressure of the child, check the functioning of the kidneys and liver.

Local or systemic causes of bleeding?

With nosebleeds, there is a violation of the integrity of the vessels localized in the mucous membrane of the organ. All the causes that can provoke pathology are divided into two groups by experts: local and systemic.

In childhood, nosebleeds can occur under the influence of the following local factors:

In addition, in childhood, nosebleeds may appear in the following cases:

too dry air in the children's room;
use of nasal sprays in the treatment of the common cold;
surgical intervention;

When exposed to local factors on the child's body, bleeding usually develops only from the right or left nostril.

Among the systemic causes that can provoke bleeding from the nasal cavity, we can distinguish:

It is important to identify the cause that provoked the appearance of nosebleeds in a child. The fact is that a small child is not yet able to explain to adults what is happening to him. Strong and frequent bleeding is a rather dangerous pathological condition, so it is imperative to show the baby to the doctor.

First aid for nosebleeds

Bleeding from the nose should be stopped as soon as possible, so parents need to:

calm the child and distract him with a toy;
ask to breathe evenly and deeply, which will slow down the speed of blood flow;
seat the child or place it in a semi-sitting position, slightly tilting his head down;
unbutton the collar and open the window, which will provide access to fresh air;
put cold on the nose and bridge of the nose, which will narrow the vessels of the nasal mucosa.

In the event that the bleeding in the child is not strong, then you need to press the wing of the nose against the septum with your finger and apply an ice pack. If bleeding is too long, a cotton ball soaked in hydrogen peroxide should be inserted into the child's nose. If after 10-15 minutes it is not possible to cope with the problem, then it is necessary to take the child to the emergency room.

If the baby is 0 to 1 year old

A common cause of nosebleeds in infants is too dry air in the nursery. In addition, the cause of such an unpleasant phenomenon can be high air temperature. Often, young parents are afraid to overcool the child and refuse to air the room daily. In such a situation, the nasal mucosa dries up greatly and the fragility of the vessels increases.

Most often, in children under one year old, blood begins to flow after a long sleep, as well as when sneezing and coughing. It is possible to eliminate an unpleasant symptom with the help of the usual ventilation of the room and maintaining the necessary humidity.

Sometimes a copious amount of blood is released from the nasal cavity of the child, and this situation is repeated quite often.

The child should be shown to the doctor and excluded:

various blood diseases;
violations in the formation of mucosal vessels;
the presence of any growths in the nose.

In addition, blood may appear during the nose cleaning procedure. This usually happens if the mother cleans it too thoroughly, which can cause significant damage to the mucosa.

Methods and treatment options

With too frequent nosebleeds from the anterior section, a treatment method such as cauterization of the damaged vessel with liquid nitrogen, laser or electric current can be used.

In case of bleeding from the posterior nasal cavity, posterior tamponade can be performed. In addition, the following hemostatic agents may be prescribed:

Vikasol;
Sodium etamsylate.

For therapeutic and prophylactic purposes, it is necessary to take Ascorutin, calcium preparations and vitamin A. With abundant blood loss, intravenous administration of solutions is carried out to restore the volume of circulating blood.

What not to do with nosebleeds

When bleeding from the nose, in no case is it allowed to tilt the child's head back. The fact is that the liquid will flow into the larynx along the back wall of the nasopharynx. After that, it may enter the organs of the respiratory system or the stomach. The consequences of such a pathological condition can be respiratory failure, coughing, vomiting with blood and bronchospasm.

With severe bleeding, it is not allowed to put the child on a pillow, you need to talk to him as little as possible. In addition, you do not need to blow your nose, as this will further increase the release of blood from the organ.

If the child often bleeds from the nose

If nosebleeds are too frequent, it is necessary to show the child to such specialists as an otolaryngologist, internist and hematologist. In addition, you need to undergo a thorough examination, which includes a detailed blood test, measurement of arterial and intracranial pressure, as well as determining the period of blood clotting.

After the examination, in the absence of any deviations from the norm, the doctor recommends:

taking drugs that help strengthen blood vessels;
fill the child's diet with products containing ascorbic acid;
strict observance of the order of the day;
as much as possible to walk in the fresh air;
moisturize the nasal mucosa.

Nosebleeds can be a sign of anemia, which is characterized by a decrease in hemoglobin. A dangerous sign is the formation of red dots on the nose.

Prevention

In the event that a child has bleeding from the nose, in order to prevent it is necessary:

review the child's diet and fill it with vegetables, fruits, cottage cheese and other foods with a sufficient content of vitamins;
wean the child from such a bad habit as picking his nose;
during the heating period, you should use a humidifier;
with a cold, do not abuse vasoconstrictor drugs;
ventilate the room as often as possible.

With too frequent nosebleeds, you should not ignore the symptom, because it can be a sign of dangerous pathologies.

The main principle of Dr. Komarovsky's work is to treat not the symptom, but its cause. He believes that it is necessary to start looking for the cause in a child from external factors affecting the body. Most often, the pathology manifests itself when the air is too dry, improper care of the child, unreasonable medication and heat stroke. As soon as it is possible to eliminate external irritants, the bleeding stops and no longer appears.

If a child often bleeds from the nose, the reasons for this may be different, so parents are advised to consult a pediatrician. If necessary, a consultation of highly specialized specialists is appointed. Signs of nosebleeds in a child appear with injuries, inflammatory lesions and vascular diseases. The phenomenon under consideration is characterized by a jet or droplet flow. Manifestations of nosebleeds in a child are often accompanied by dizziness, loss of consciousness. The child may have hypotension, tachycardia, general malaise, and sudden weakness.

Etiology of pathology

Nosebleeds in children have different causes. The condition occurs suddenly. It is not dangerous if there are no additional symptoms. But with frequent manifestations of bleeding from the nose, you need to see a doctor.

Why is the child bleeding from the nose? The phenomenon under consideration is observed in 6 out of 10 children. The main cause of bleeding is injury. Sometimes the condition can indicate a more serious health problem.

Nosebleeds are more common in children under 10 years of age. The peak of the greatest "popularity" falls on 3-8 years. There is no clear answer why bleeding occurs. But there are a number of assumptions about the nature of this pathology:

scratches, bites;
foreign objects in the nose;
influence of excessively dry climate or air conditioner;
allergies;
infections;
chronic liver pathology;
the use of blood-thinning drugs;
pressure rise;
migraines are the main reason why a child can bleed from the nose;
damage to the CS is observed in the winter period or with lesions of a genetic nature;
juvenile form of nasal angiofibroma;
nervous disorders;
nose damage;
neoplasms of a different nature.

Nosebleeds in teenagers appear suddenly and involuntarily. Sometimes they are provoked by action from the outside. The etiology of the condition under consideration can be general or local.

Classification of the etiology of nosebleeds

Why does the child often bleed from the nose? Local causes of damage include:

injuries of various strength and nature;
the presence of a foreign body in the nose;
vascular anomalies;
medical manipulation.

Why is the child bleeding from the nose? General lesions include many diseases and pathological changes that lead to problems with blood clotting or with the permeability of the walls of blood vessels:

coagulopathy (including hemophilia), which are characterized by the absence or deficiency of blood clotting factors;
vasculitis - inflammatory changes in which an increased permeability of the walls develops;
if the blood flowed due to beriberi, vitamin therapy is prescribed;
pathology is provoked by decompensated liver lesions (chronic forms of hepatitis, cirrhosis);
chronic sinusitis, adenoiditis, atrophic rhinitis;
blood flows with changes in atmospheric pressure;
hormonal disorders in adolescence.

Bleeding from the nose can indicate a serious disorder in the body. The manifestation is a recurrent or episodic symptom of a developing pathology. First aid for nosebleeds in children should be provided in a timely and correct manner by a pediatrician or hematologist. Laboratory tests are mandatory.

Condition pathogenesis

The blood from the nose of a teenager is divided into 2 types according to their location:

anterior nosebleeds;
back.

In the first case, the process occurs on the front of the nose from one nostril. This is the majority of all nosebleeds. Such secretions provoke conditions in which a vessel located on the septum bursts. It is more difficult to help a child with simultaneous damage to several CSs.

Epistaxis in posterior children is rare. This is a more dangerous condition that is not easy to control. How to stop a nosebleed in a child? Most often, with such bleeding, it is difficult for parents to stop the discharge on their own. Therefore, medical attention may be required. Pathology occurs against the background of increased pressure or as a result of trauma.

If the child has back bleeding, you need to call an ambulance. The pathology is deep, profuse, and poses a great risk to the airways. The condition is complicated by aspiration of blood.

Babies often bleed from the nose from only one nostril. In severe cases, it can get into the throat, causing hemoptysis, anemia. With significant blood loss in children at the age of 8, dizziness and delirium may occur. This condition accompanies frequent bleeding. Often, a loss of consciousness is noted if the child has a nosebleed.

Diagnosis and treatment of pathology

What to do with heavy bleeding? Severe blood loss requires hospitalization. Specialists should conduct a rhinoscopy examination using dilators and a rhinoscope. The degree of blood loss is assessed. Usually, such procedures are sufficient to identify the source of the pathology and the complexity of the condition.

Often, treatment for the condition is minimal. Only in severe cases, with uncontrolled bleeding, medical intervention is indicated. After a medical assessment, one can judge the condition of the child and the complexity of the disease. In addition, doctors evaluate the indicators of pulse, pressure. Only a comprehensive examination allows you to make a final diagnosis. Therefore, if the nose bleeds, this is a reason for undergoing specialized treatment. You must first take an x-ray to exclude trauma and the presence of a foreign body in the nose.

How to stop nosebleeds? First aid steps for nosebleeds in children:

During an attack, you need to calm the child (the phenomenon in question provokes fear, tachycardia and hypertension).
If a child bleeds at two years old, he is seated on a chair, lowering his head down. This action prevents it from flowing into various organs, including the esophagus. If a child has frequent nosebleeds, he should not lie down horizontally. This position only increases their rush to the head, increasing the amount of bleeding.

During first aid, do not tilt the child's head back. Blood will enter the throat, causing coughing, increasing bleeding. In such cases, you need to run to the hospital. The child needs the help of qualified specialists.

If strong blood has gone from a child at 10-11 years old, it is recommended to put a container in front of him (to collect the flowing fluid). This action will allow you to estimate the amount of blood loss. It is recommended to monitor the child with a frequency of 5-10 minutes. Additionally, clothes are unbuttoned to provide better air supply.

Before stopping the bleeding from the nose, it is necessary to explain to the child that you need to inhale air through the nose and exhale through the mouth. If the phenomenon in question is observed in a child of ten or eleven years, it is recommended to take him to the nearest hospital department. This is due to the fact that this category of children is characterized by a wide list of causes of nosebleeds. Before providing professional medical care, the damaged nostril is pressed against the septum for several minutes. This action helps to stop the bleeding in children as young as three years old.

If a 14-year-old teenager has injured his nose and bleeds, apply cold (wet tissue, ice). This allows you to reduce its supply to the affected area. Children 6 years old can make a cotton swab dipped in hydrogen peroxide, Naphthyzinum.

When bleeding from one nostril in a one-year-old child, you need to raise your hand on the side of the lesion and press the nostril from which blood flows. There may be bilateral bleeding - raise up 2 hands. If there is blood from the nose of a child at 2 years old due to the presence of a foreign body, self-medication is contraindicated. There is a risk of worsening the condition of the child. Parents, trying to help him, displace the foreign body into the respiratory tract, provoking an asthma attack. Only an ENT should remove a foreign body from the nostrils.

When blood flows from the nose, it is important to constantly monitor the condition of the child. His pulse, pressure and respiratory rate should be periodically measured. If the bleeding has stopped, the nasal passages are treated with vaseline oil. The procedure will prevent the drying of the mucous membrane of both a child at 4 years old and a teenager.

The patient is plentifully soldered to replenish the volume of circulating fluid in the body. This is an additional way to stop blood loss. Do not forget about the temperature regime of the room. It is important to periodically humidify the air in the room with a humidifier or with wet sheets. Drying of the mucous membranes is well prevented both in children at the age of 5 and in adolescents at the age of 17 drops of Aquamaris, Salin.

Medical treatment

First of all, it is important to determine the root cause of the disease. Only after this is assigned one of the methods of therapy:

Use of creams or ointments, including neomycin. At the initial stage, drugs are used twice a day until the discharge stops completely. When the cause is eliminated, the means are applied as needed. Restoration of the mucosa lasts up to a month.
Cauterization of the partition. The event is performed in a young child with frequent episodes of bleeding. The intervention is performed due to the influence of silver nitrate, chromic or chloroacetic acid. If the nose bleeds often, this procedure is the only radical way to overcome the pathology. Young age is not a contraindication to the operation. The intervention is performed under local anesthesia. The baby recovers after the procedure for several days.
If blood often bleeds in children at the age of 10, hemostatic sponges, tampons with feracryl, amnion or dry thrombin are used to stop it.
Children at the age of 3 can be prescribed drugs that increase the clotting of the "red liquid". These include calcium chloride, ascorbic acid, calcium gluconate.
Adolescents have their arteries tied off, which often bleed.
In severe cases, when blood loss is significant, a transfusion of whole blood or its components is mandatory.
Nasal tamponade is the most accessible and effective method by which it is possible to suddenly stop the bleeding. The wound is filled with tampons, which are removed after 1-2 days. A longer stay of tampons in the nose causes sinusitis.

Frequent discharge is a reason to consult a doctor. The help of specialists is necessary if the process in question does not stop. First of all, you need to go to the ENT, otolaryngologist and pediatrician.

Disease prevention

The appearance of pathology in the nose can be prevented. To this end, the following recommendations have been developed:

Air humidification in the children's room.
Nose injury prevention.
The use of drops that moisturize the mucous membrane if there is a nosebleed every day.
After an episode of bleeding, the child should refrain from playing sports for several days.
Children should be spoken to, explaining to them what to do when nosebleeds begin to stand out.

By following the above recommendations, you can minimize the frequency of the clinic, which is characteristic of a condition when a vessel in the nose is constantly bleeding. If, against the background of the symptoms, the child's condition becomes worse, an ambulance is called. Similar actions are taken when the bleeding does not stop or is severe. It is difficult to establish the cause of the phenomenon under consideration, especially in young children. You can not self-medicate, then the clinic only gets worse. Children who are in serious condition may require hospitalization. Find out when it is necessary, only a doctor can after examining the patient.