Nasal bleeding in children is a common phenomenon. In the hot climate of summer and the dry indoor season of winter, pediatric nosebleeds are more frequent, especially some children often have nosebleeds at night, and many parents cannot help but worry about this. There are many causes of nasal bleeding in children, and the site of nasal bleeding in children is mostly in the capillary network area in the anterior part of the nasal septum bilaterally, also called the Lithia area. This vascular network is very superficial and is distributed in the mucosal layer of the nasal septum.
The causes of nasal bleeding in children are broadly as follows.
1, trauma: the nose is an organ exposed to the body surface, once trauma occurs, such as blows and bruises, the nose naturally be the first to bear the brunt. Under the impact of severe trauma, the blood vessels under the mucous membrane will rupture and bleed.
2.Nose picking: Strictly speaking, nose picking should also be included in the scope of trauma. Children often like to dig blindly with their fingers in the nasal cavity out of curiosity and embarrassment, which is an unhygienic and unhealthy habit that can easily cause local mucosal bleeding in the nose. The general digging site is under the front of the nasal septum, and there are many blood vessels in this area, many tiny blood vessels are interwoven into a series of mesh, like a spider web, the blood vessels are superficial and very fine, the site is in the nasal cavity mouth, as long as the hand digging, you can dig through the blood vessels. More than 90% of children’s nosebleeds are here.
3, acute febrile infectious diseases: during childhood, there are often some infectious diseases with rapid onset and high fever, especially upper respiratory tract infections are more common. When high fever occurs, the blood vessels of the skin and mucous membranes throughout the body become congested and swollen, and the same pathological changes occur in the nasal mucosa.
4, nasal foreign body: some foreign bodies swell and mold in the nasal cavity with water, causing nasal mucosa infection, erosion and bleeding, sometimes under the bad stimulation of foreign bodies, the nasal mucosa can also cause traumatic bleeding.
5, rhinitis, paranasal sinusitis: children are also prone to acute and chronic rhinitis and paranasal sinusitis. Once this inflammation occurs, the mucous membrane in the nasal cavity or paranasal sinus becomes congested and swollen, and from time to time there is mucopurulent nasal discharge, and under the stimulation of purulent nasal discharge, the blood vessels under the mucous membrane will also bleed.
6, blood diseases: under the action of certain factors, some factors in the blood will undergo a series of changes, so that the blood vessels and blood will not be easy to coagulate after the occurrence of bleeding, these diseases are leukemia, hemophilia, thrombocytopenic purpura, aplastic anemia, etc., collectively known as blood diseases, which are the direct cause of nasal bleeding in children, and will cause repeated and massive bleeding.
Treatment of nosebleeds
Doctors often meet very anxious mothers who bring their children to the clinic and cry out “doctor, save my child” before they enter the clinic, and suddenly they see a child with a face full of blood being carried in. Liu Tao, attending physician of the rhinology department of Xiamen Hospital of Traditional Chinese Medicine, told the child’s mother: Please don’t be anxious, although rhinorrhea looks fierce, in fact, if handled properly, it can achieve very good results. So how do we deal with nosebleeds? Dr. Liu tells you that we can do the following.
1, the occurrence of nasal bleeding, if the amount is large, let the patient take a sitting or semi-recumbent position, while comforting the patient, so that he avoids excessive tension, try to maintain sedation. First of all, maintain the correct posture.
2.Local treatment is mainly to stop bleeding by compression
(1) Let the patient pinch both sides of the nose with the thumb and index finger for 5-10 minutes to stop the bleeding.
(2) If the bleeding does not stop, a clean cotton ball, gelatin sponge, soft cloth, etc. can be inserted into the nasal cavity to stop the bleeding by compression.
(3) Cold water towel or ice pack can be applied to the forehead, nose, neck or occipital area and changed repeatedly to induce vasoconstriction and reduce bleeding.
(4) If there is repeated bleeding or a lot of bleeding, you need to go to the hospital immediately and let the doctor take care of it. The doctor will first clean the nasal cavity to find the bleeding site as far as possible, and then use sterilized petroleum jelly gauze to fill and press on the bleeding site to stop the bleeding or give more targeted microwave or plasma electrocoagulation to stop the bleeding.
Prevention of nosebleeds
How to prevent nosebleeds in children? Dr. Liu reminds us that the dry climate in autumn and winter increases nosebleeds in children. In addition to seasonal factors, most children nowadays are partial eaters, loving only meat and not vegetables, and their nutritional intake is not comprehensive, so that it causes an increase in the brittleness of blood vessels is also one of the important reasons. Some children have bad habits, such as rubbing their nose vigorously, which leads to the rupture of small blood vessels in the nose. Some are also related to diseases, such as blood disorders, fever, cough, etc.
The occurrence of nosebleeds in children can be more effectively prevented by using the following ways.
1.Prevent nasal bleeding by applying oil: For children with a history of nasal bleeding, families should have gentamycin eye ointment, which can be applied evenly in the nasal cavity every day when the child’s nasal cavity is dry to moisten the nasal mucosa and glycerin drops; you can also wipe the nasal cavity with a cotton ball dipped in clean water.
2.Control children’s strenuous activities and avoid nasal trauma. Children’s nasal bleeding does not exclude some local inflammation of the nasal cavity, such as acute and chronic rhinitis, sinusitis, strenuous activity will cause the nasal mucosa blood vessels to dilate, or lead to nasal itching children picking and nasal bleeding. To let children develop good habits, do not pick when the itchy nose.
3. Pay attention to the diet. In autumn and winter, things are dry, diet must be careful. Do not eat more fried and fatty items, eat more fresh vegetables and fruits, and pay attention to drink more water or cool drinks to replenish water, if necessary, you can take appropriate amounts of vitamin C, A, B2. Correct the child’s habit of partial food, drink more water, eat more vegetables, reasonable and scientific arrangement of the child’s diet.
4. Prevent colds and other respiratory diseases. Now is the high incidence of upper respiratory diseases, if the child suffers from colds, tonsillitis, pneumonia or mumps and other infectious diseases, can lead to congestion and swelling of the blood vessels of the nasal mucosa, and even cause capillary rupture and bleeding.
5, repeated nasal bleeding must go to the hospital for examination.