Nosebleeds Staunch Techniques to Stop the Flow

Staunch Techniques to Stop the Flow

It can be a horrifying experience for a small child--and for a parent. Small noses can produce alarming amounts of blood, and all that unexplained blood can scare the bravest of kids.

''Once my five-year-old son woke up in the middle of the night to find his pillow, pajamas and face covered with blood,'' recalls Cynthia Sloan, a suburban Philadelphia mother of three. ''His screams brought me running. It only took a second to know why he was so terrified--it looked like a massacre had occurred in his bed.''

But nosebleeds are seldom anything to worry about. ''They almost always look worse than they are,'' says Orval Brown, M.D., associate professor of otolaryngology and chairman of the Division of Pediatric Otorhinolaryngology at the University of Texas Southwestern Medical Center in Dallas.

Most nosebleeds in children are the result of too vigorous blowing, an accidental smack in the nose during rough-and-tumble play or some reckless picking with a sharp-nailed finger. ''The scratch that causes all that blood is usually minor,'' says Jonas Johnson, M.D., professor of otolaryngology and vice chairman of the Department of Otolaryngology at the University of Pittsburgh School of Medicine, and most nosebleeds can be stemmed easily at home.

But once the bleeding has stopped, your job still isn't over. ''Complete healing requires seven to ten days,'' says Dr. Johnson. During that time you'll want to take preventive steps to help keep the scab in your child's nose intact and avoid another nosebleed.

Here's what the experts recommend to stop the flow and help prevent recurrences.

Treatment

Reassure your child. First, make sure you remain calm. ''If your child sees that you're upset and scared, he will be, too,'' says Dr. Johnson. Explain to your child in calm tones that the nosebleed isn't serious and that you can stop it quickly with your child's help.

Try a nasal spray decongestant. If you have one on hand, you could try an over-the-counter product such as Neo-Synephrine or Afrin. These are vasoconstrictors that shrink blood vessels and help a scab form, says Dr. Johnson. ''This may help speed up the process,'' he says.

Pinch the nose shut. With your child upright in a chair or in your lap, gently squeeze the soft part of the nose shut with a tissue or clean washcloth, says Dr. Johnson--or have your child do it. ''Holding the nose shut firmly for ten minutes will almost always stop the bleeding,'' he says. ''The aim is to get a clot to form at the site of the injury.''

Be sure that your child doesn't lean back, which can cause blood to flow down the back of the throat. This not only tastes bad and can initiate a coughing fit, but the blood can also irritate the stomach and cause vomiting, says Dr. Brown.

Be a clock watcher. When you're holding a child and pinching his nose shut, ten minutes can seem like a long time, admits Dr. Johnson. But don't give up too soon. ''To be sure you've pinched your child's nose long enough, set a timer or sit near a clock,'' he suggests. If you don't hold the nose long enough, the bleeding will start again shortly after you let go.

Chill out. In addition to holding the nose shut, a cold cloth against the back of the neck or bridge of the nose can constrict blood vessels and help stem the flow, says Susan Fuchs, M.D., assistant professor of pediatrics at the University of Pittsburgh School of Medicine and an attending physician in the emergency department at the Children's Hospital of Pittsburgh.

Distract your child. ''To help keep your child sitting that long with a pinched-shut nose, talk to him about what you're doing and why you're doing it,'' suggests Dr. Johnson. Other ways to distract him: Read a favorite story aloud, or watch a television show or video together.

Preventive Care

Don't blow it. After your child has a nosebleed, ''don't let her blow her nose, no matter how stopped-up it feels,'' says Dr. Fuchs. ''The simple act of blowing the nose can dislodge the delicate clot and start the bleeding all over again.''

Curb physical activity. For several hours after the nosebleed has stopped, keep your child quiet and inactive. And ask your child not to run hard or to do things like hang upside down from the monkey bars until the damaged nose is completely healed--at least a week later. ''Strenuous activity increases the pressure on blood vessels and can cause the nosebleed to start up again,'' says Dr. Johnson.

Discourage picking or rubbing. ''Picking is probably what started the whole mess,'' says Dr. Fuchs, admitting that keeping a child from nose-picking is no easy task. ''Even rubbing the nose, which will feel itchy as it's healing, can start the bleeding again,'' she adds. You can trim your child's nails to lessen the damage. If your child tends to pick in his sleep, slip socks or gloves on the hands at bedtime to help prevent another bleeding episode.

Humidify your home. Homes with dry heat can also dry out the nasal passages, making nosebleeds more likely. ''A vaporizer can help in those cases,'' says Dr. Fuchs. Make sure you clean the vaporizer often, following the manufacturer's instructions.

Keep it moist. To humidify your child's nose directly, use a saline solution, suggests Dr. Brown. ''Add ¼ teaspoon of salt to a cup of warm water, and put it in a nasal spray bottle that has been washed out,'' he says. Warm the bottle under running hot water until it's body temperature, and then spray three or four spritzes inside your child's nose. You can also purchase saline nasal spray at the drugstore, says Dr. Brown. The only drawback of the homemade solution is that it won't keep more than three days.