What should I do if a child has a nosebleed?

Generally, nosebleeds in children may be caused by factors such as fragile nasal mucosa, dry environment, nasal foreign bodies, allergic rhinitis, and acute rhinitis. It is recommended to seek timely medical attention, identify the underlying cause, and undergo symptomatic treatment under a doctor's guidance. Detailed explanations are as follows:

1. Fragile nasal mucosa: Children have tender nasal mucosa with abundant and superficial blood vessels underneath. Minor irritation can cause blood vessels to rupture and bleed, usually involving only one nostril and producing minimal bleeding. When a child experiences a nosebleed, have them lean forward with their head down and pinch both sides of the nose with their fingers for 5-10 minutes to apply pressure and stop the bleeding. After the bleeding stops, avoid rubbing the nose. Regular use of normal saline nasal spray can help moisturize the nasal cavity and reduce mucosal damage.

2. Dry environment: Dry air can cause moisture loss from the nasal mucosa, making it dry and fragile, which can easily lead to nosebleeds accompanied by a sensation of heat in the nose. Place a humidifier indoors to maintain humidity between 40% and 60%. Encourage children to drink more water and avoid staying in dry environments for prolonged periods. Applying erythromycin ointment inside the nasal cavity can help protect the mucosa.

3. Nasal foreign bodies: During play, children may insert small toys or paper balls into their nasal cavity. Foreign bodies can irritate the mucosa, causing congestion and infection, which may lead to nosebleeds accompanied by unilateral nasal obstruction and an unpleasant odor. Prompt medical attention is necessary for removal of the foreign body by a doctor. Avoid trying to remove it yourself, as this may damage the mucosa. If infection occurs after removal, follow the doctor's instructions to use anti-infective medications such as cefaclor dry mixable suspension or amoxicillin-clavulanate potassium granules to promote mucosal recovery.

4. Allergic rhinitis: Exposure to allergens can trigger rhinitis, causing nasal mucosal congestion and edema. Frequent sneezing or rubbing the nose can lead to bleeding, accompanied by nasal congestion, runny nose, and nasal itching. Parents may follow medical advice to administer medications such as mometasone furoate nasal spray, loratadine syrup, or cetirizine hydrochloride drops to alleviate allergic symptoms and reduce mucosal irritation. Additionally, avoid exposure to allergens and regularly clean the indoor environment.

5. Acute rhinitis: Viral or bacterial infections can cause acute rhinitis, resulting in red and swollen nasal mucosa with dilated blood vessels that are prone to rupture and bleeding, accompanied by nasal congestion, runny nose, and fever. Parents may follow medical advice to use normal saline to irrigate the nasal cavity and relieve mucosal congestion. Viral infections can be managed with pediatric paracetamol and chlorpheniramine maleate granules to alleviate symptoms, while bacterial infections require anti-infective treatment with cefixime granules or azithromycin dry suspension. Bleeding will stop once the inflammation subsides.

In daily life, educate children not to pick their noses and avoid severe nasal trauma. Regularly trim their fingernails to reduce mucosal damage when rubbing the nose. If nosebleeds occur frequently or involve heavy bleeding, record the details and inform the doctor to help identify the cause and implement targeted treatment, thus protecting the child's nasal health.