Nasal bleeding in children is a common phenomenon. In the hot summer climate and dry winter season, pediatric nosebleeds are more frequent, especially some children often have nosebleeds at night, and many parents cannot help but worry about this. Every summer is the season of the year with the highest incidence of nosebleeds.
Causes of pediatric nosebleeds The site of pediatric nosebleeds is mostly in the capillary network area in the anterior part of the nasal septum bilaterally, also called the Lai’s area. This vascular network is superficial and is distributed in the mucosal layer of the nasal septum. The main causes of pediatric rhinorrhea are: 1. Nasal bleeding is likely to occur when the nasal mucosa is dry, capillaries are dilated, there is nasal inflammation or stimulation, such as various rhinitis, sinusitis, nasal tuberculosis, nasal syphilis, nasal trauma, nasal septal deviation, nasal foreign body or nasal tumor.
2.Poor climatic conditions, such as dry air, heat, low air pressure, cold, high room temperature can cause rhinorrhea.
3.Some children have the bad habit of picking their nostrils with their hands. When the nasal mucosa is dry, it is easy to pick the nose and bleed.
4.Picky eating, partial eating, not eating green vegetables and other bad habits in the diet can also cause nasal bleeding due to vitamin deficiency.
5.Blood system diseases and certain systemic diseases.
Performance of pediatric rhinorrhea When rhinorrhea occurs, blood flows out from the front nostril or flows to the pharynx through the back nostril, and the two conditions can occur at the same time when the bleeding volume is large. This is because when the nosebleed is serious, more blood is swallowed and stimulates the stomach, which can cause abdominal pain, pallor and sweating, and also vomit out coffee-like substance, that is, the reaction between stomach acid and blood, causing the blood to turn coffee-colored. The nosebleed can be swallowed and discharged through the gastrointestinal tract, and black stool can also appear. Therefore, when nosebleed, try not to lie down to prevent the blood from being swallowed through the pharynx.
Handling of pediatric nosebleeds 1. Adults should first try to calm themselves and not panic in order to calm children who are frightened by bleeding.
2. The head should be kept in a normal upright or slightly forward position. Do not lie down to prevent blood from being swallowed through the throat.
3.Press the front part of the nose (soft nose) on the bleeding side with your fingers from the outside of the nose, similar to the general practice of pinching the nose with your hands, and press directly for about five to ten minutes. Most patients can simply stop the bleeding in this way. The photo below is my approved method.
4.If the blood does not stop after ten minutes of compression, it may represent serious bleeding, or other problems exist, and it is necessary to send to the doctor for further treatment.
5.The role of “ice on the forehead” is to stop the bleeding by cold skin on the forehead to achieve nasal vasoconstriction, but the effect is not good because the nostril area is too far away from the bleeding, and the local too cold will cause head discomfort. Most children with nosebleeds can stop bleeding quickly by pressure.
6. In the hospital, doctors will give appropriate treatment according to the site of nasal bleeding and the amount of blood. Most nasal bleeding in children occurs in the “Lai’s area” where the first third of the nasal septum is rich in blood vessels, and can be treated locally with freezing, microwaves and chemicals if there is repeated bleeding here. The efficacy of these methods is more or less the same. Our hospital uses silver nitrate bead cautery method for treatment. Regardless of the method, the effect varies from person to person, and it is impossible to “eradicate” the problem. Generally, as we age, the mucous membrane thickens and the capillary network becomes deeper, nasal bleeding will gradually decrease.
It should be emphasized that the treatment of nasal bleeding should start from the cause. If the nasal bleeding is caused by various rhinitis, we should treat the rhinitis first; if the nasal bleeding is caused by trauma or nasal foreign body, we should deal with the trauma and remove the foreign body; if the nasal bleeding is caused by allemic diseases, such as scarlet fever, upper respiratory tract infection and blood diseases, including leukemia, hemophilia and thrombocytopenic purpura, we should treat these diseases.
Precautions for pediatric rhinorrhea 1. Avoid panic. Children are still young, when bleeding occurs suddenly, often helpless. At this time, parents should first calm down, can guide the child to do slow and deep breathing, in order to fully relax.
2. Do not lie on your back. Do not let the child lie on his back when the nose bleeds. Because when lying on his back, blood will flow from the back wall of the throat into the esophagus and stomach, and will soon be vomited from the stomach again, which hides the truth of nosebleeds. Let the child take a sitting or semi-sitting position, pay attention to keep the respiratory tract open to prevent the blood from flowing into the mouth through the posterior nostril, and instruct the child to spit out the blood flowing into the mouth as much as possible to prevent the blood from being swallowed to stimulate the gastrointestinal tract causing nausea, vomiting or the child accidentally inhaling the respiratory tract and causing asphyxia.
3, do not use paper rolls, cotton plugging. This not only can not play a role in stopping the bleeding, unclean paper rolls and cotton will instead cause inflammation.
4, is to tightly press the nose. Parents should use the second knuckle of the thumb and index finger to tightly press the child’s bilateral nasal flanks, because the child’s nasal bleeding is generally in the front of the nasal septum, compression of the bilateral nasal flanks can generally stop the bleeding.
Prevention of pediatric rhinorrhea 1. In the dry season, for children with a history of rhinorrhea, families should have erythromycin eye ointment, which can be applied evenly in the nasal cavity every day to moisten the nasal mucosa.
2. Correct the child’s habit of partial eating, drink more water, eat more vegetables and arrange the child’s diet in a reasonable and scientific way. Avoid eating greasy and inflammatory foods: potato chips, cookies, cinnamon, oranges, etc.
3, the child occurs in the evening nasal breathing is not smooth, should go to the hospital, and never pick the nasal cavity.