● In the outpatient clinic, parents often come to consult, what is the child's total nosebleed? Does it matter? How should it be treated? For children and adolescents, especially preschoolers, nosebleeds are common. Children's epistaxis are mainly because the mucosa of the nasal septum of the child is often very thin, and the capillary network in the lower part of the anterior septum is very rich, so it is very easy to cause mucosal damage under the action of external triggers or their own factors, which then causes the rupture of arterioles or capillaries and the occurrence of nosebleeds.
· Common triggers for nosebleeds
The common causes of nosebleeds in children are mainly the following:
Dry In autumn and winter, the climate is dry, especially in the northern regions, and the interior becomes drier after heating and heating. Dry air increases the fragility of the nasal mucosa in children, which can lead to frequent nosebleeds.
Inflammation Acute, chronic, allergic, non-allergic inflammation of the nasal sinuses can induce nosebleeds. When children suffer from inflammation of the nasal cavity or sinuses, they often have symptoms such as nasal congestion, nasal itching, and runny nose, and will subconsciously rub, pick, and blow, which can easily damage the fragile mucous membrane of the nasal cavity, cause blood in the nasal cavity, and repeatedly multi-amount nasal bleeding will occur in the heavy cases.
Bad habits Nasal secretions dry and scabbed after the formation of what we often call snot, will cause discomfort, many children are accustomed to using their fingers to pick the nose. This behavior can easily damage the mucous membrane that protects the blood vessels, and nosebleeds can occur after capillary injuries.
Other upper respiratory tract infections, nasal or sinus foreign bodies, tumors, strenuous exercise, etc. can also cause congestion and swelling of blood vessels in the nasal mucosa, which in turn can lead to nosebleeds.
· Nosebleeds don't stuff toilet paper
Epistaxis in children is an emergency, and once it occurs, it should be stopped in time. An easy way is to stuff the bleeding nostrils with a sterilized cotton ball or pinch both nasal wings with your thumb and index finger, or you can use your index finger to compress the affected nose wings for 5 to 10 minutes to compress and stop the bleeding.
Parents should try to keep their children quiet at this time and avoid crying. It is best to let the child take a seat, tilt the head forward slightly, and try to spit out the blood flowing into the mouth, so that you can know the amount of bleeding and avoid swallowing the blood into the stomach, stimulating the stomach to cause abdominal pain and vomiting.
Some people mistakenly believe that lowering your head will make nosebleeds easier to flow out, and looking up will help stop bleeding, but in fact, the opposite is true. Most of the children's nosebleeds occur in front of the nasal cavity, if you look up, the blood will flow to the back of the nasal cavity, the mouth, the trachea and even the lungs, easy to cause swallowing and aspiration, light caused gastrointestinal discomfort, heavy can cause tracheitis, pneumonia, and even tracheal blockage, breathing difficulties.
Parents can use ice packs or wet towels to coldly apply to the forehead, neck side, occipital part of the child, or wash the nose with cold water and ice water to constrict the blood vessels and reduce bleeding. Many parents who encounter a nosebleed from their child will first think of blocking the nostrils with a tissue, which is not recommended. This is because the pressure of the tissue is usually not enough to achieve the effect of hemostasis, and the tissue is not sterilized, which is easy to induce infection.
After finger compression and hemostasis, if the nosebleed cannot be stopped, and the amount of bleeding is large, when the child has symptoms of hemorrhagic shock such as pallor, sweating, fast heart rate, and poor mental health, the child should be allowed to use the semi-recumbent position and be sent to the hospital for treatment as soon as possible.
If there is recurrent nosebleed, and the bleeding site is clear and localized, radiofrequency or electrocoagulation can be performed to stop bleeding, which is relatively simple. For older children, surgery under local anesthesia may also be tolerated if mild pain can be tolerated.
If your child has repeated nosebleeds, accompanied by other symptoms, such as fever and other physical discomfort, he should go to the hospital for examination to see if there are other diseases such as inflammation of the nasal cavity or sinuses, foreign bodies in the nasal cavity, benign and malignant tumors of the nasal cavity, sinuses, nasopharynx, blood diseases and so on. If it is a systemic disease caused by nosebleeds, such as scarlet fever, blood diseases (including leukemia, hemophilia, thrombocytopenic purpura, etc.), it is necessary to go to the corresponding department for the primary disease and treat it as soon as possible.
· Life starts to prevent nosebleeds
For nosebleeds caused by dry weather, emphasis should be placed on prevention. When the child's nasal cavity is dry, parents can wipe the nasal cavity with a disinfectant cotton ball dipped in normal saline to clean up the scab in the nasal cavity in time. In addition, a humidifier can be used at home to maintain room humidity. If there is no humidifier, you can put a basin of water next to the heating in the room, which can also achieve the purpose of increasing air humidity.
Parents should tell their children not to use their hands to pick their noses. For nosebleeds caused by inflammation of the nasal cavity, aggressive treatment should be carried out. When inflammation in the nasal cavity is controlled, the situation of nosebleeds will also improve.
Winter weather is dry, to prevent nosebleeds, diet should also pay attention. Parents should give their children less fried and greasy food, eat more fresh fruits and vegetables, and pay attention to drinking more boiled water and drinking less. During nosebleeds, do not eat hot food, drink hot drinks, should eat some mild, soft food, such as porridge, noodles, etc., to avoid spicy irritation and hard food.
Strenuous activity can also dilate the blood vessels of the nasal mucosa, so strenuous exercise should be avoided during periods of nosebleeds. If the child suffers from infectious diseases such as upper respiratory tract infections, tonsillitis, pneumonia, and mumps, it is easy to cause congestion and swelling of blood vessels in the nasal mucosa, resulting in rupture and bleeding of capillaries. Therefore, the prevention of nosebleeds, respiratory diseases can not be ignored.
Text: Zheng Ming, deputy chief physician of the Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University
Source: Health Newspaper