I was never a nosebleed kind of kid. There was one girl in my elementary school who I think spent most of the 3rd and 4th grades lying in the back of the classroom, actively hemorrhaging while the rest of us did social studies. But I can’t recall ever having had anything remotely as impressive as that. Of course, I’ve taken care of plenty of bleeders over the years in the ER. Nosebleeds are the number one cause of vomited blood, did you know that? Yep, it’s true. And the number one cause of nosebleeds? Well, we call it “digital trauma.” (That’s a finger, if you didn’t get it right away.) The most common place in the nose a kid will bleed from is the fragile blood vessels in the front part of the nostril. If the skin over these vessels becomes irritated or damaged, they bleed. So, basically, most kids with nosebleeds are nose pickers That’s a very basic tenet of emergency room nosebleed management.
Of course, there are other causes of nosebleeds. For example, I read a case report once of a baby with a congenital heart condition that caused high blood pressure, which led to a nosebleed. And then there are other fairly common causes like being bopped in the face. Kids with colds or allergies and those exposed to very dry air are more likely to have a nosebleed. A Lego or a Barbie shoe up there might cause a little local trauma. Cocaine use is slightly less common in my patient population but it’s on the list. As are bleeding disorders, certain medications and chronic liver and kidney conditions. Oh, and did I mention picking?
Anyway, I won’t tell you which activity all 3 of my kids enjoy immensely that appears on the above list. But there is one and unfortunately for Zoe, she’s either unduly aggressive or just extra sensitive. Either way, it started while we were skiing over the holidays (Let’s blame the thin, cold, dry air!!). Zoe’s a quick learner and now all we hear is a little whimper as she pinches her nostrils and leans her head slightly forward, just like Mommy taught her. (That kid lying down in the back of social studies probably spent her whole night puking. Tummies don’t like blood. They tend to kick it back out. So the best thing to do during a nose bleed is lean forward and spit.) Someone runs for a tissue. Someone else (me) runs for the stain removal spray. And we wait. 5 to 10 minutes.
So the other day I took Zoe to run some errands. I know there are some mothers who are “always prepared.” I’m not. I’m more of the “Ah, I bet that diaper will make it to the store and back” kind of mom. Which means when Zoe began to bleed, I had nothing to offer her. Well, except this:
Hey, it did the trick. Anyway, having now completely humiliated my young daughter, let me remind you that nosebleeds looks scary but really are very common. Most kids will stop bleeding within a couple of minutes. If you’ve got a kid like Zoe, remember to pinch the front of the nose (where those pesky vessels are) and tilt her head forward. Call your doctor if the bleeding doesn’t stop pretty quickly or is associated with any other symptoms such as unusual bruising or signs of a head injury. Get her to spit out the blood instead of letting it run down the throat into the stomach.
And remember to carry tissues with you at all times.