Even in small children and older adolescents, occasional nosebleeds are not initially a cause for concern, even if the excitement caused by the bleeding is correspondingly great in children. During the growth process, this is caused by very thin-walled vessels directly under the surface of the mucous membrane, which are less able to withstand a wide variety of stresses and strains than adults. In some cases, children’s nosebleeds can occur at night without any apparent reason.
During the care of the child, the main focus is on calming the child down, since the bleeding stops less easily when the child is agitated. It is not always easy for the parents concerned to radiate calm and serenity towards the child, but it is helpful to tell or read a story to the child who is sitting quietly after the general measures such as cooling the child’s neck have been initiated. The child should sit in order to allow the blood to drain better and to keep the blood pressure in the head as low as possible compared to the lying position.
If pressure is applied to the nose to stop bleeding, or if nasal breathing becomes difficult during bleeding, care must be taken to ensure that the child gets enough air through the mouth. It must also be ensured that the child does not swallow blood or, in the worst case, that it does not run into the windpipe or breathe in. If complications arise in this respect or if the nosebleed does not stop within twenty minutes, an otolaryngologist should be consulted.
However, if the nosebleed has spontaneously stopped before, the child should not romp around for the rest of the day, as the vessel that is currently healing could otherwise tear open again. Strong blowing of the nose and nose-picking may also have been the triggering cause, as well as the fact that they are unfavorable and must be stopped after the spontaneous end of the nosebleed. It should also be ensured that the child’s nosebleed was not caused by a foreign body pushed into the nose, or that an accident such as a fall on the head (skull base fracture) or nose occurred. In case of suspicion of such a case or in case of concomitant injuries, it is recommended to consult a doctor.
