Nose bleeds
Nose bleeds are a common childhood condition and are normally self-limiting. It is most commonly caused by minor injury to the nose lining such as nose picking but can also be caused if your child has had a recent cough/runny nose (viral upper respiratory tract infection), if they have allergic rhinitis, or a foreign body in their nasal passage. Only very rarely can it be due to a bleeding disorder. The bleeding is usually from the front part of the nose and whilst the amount of bleeding may seem like a lot (such as soaking through tissues), it is rare for children to lose so much blood that it causes any problems (such as anaemia). This is only to be likely with frequent, heavy nosebleeds over several weeks or months.
If your child has any of the following:
- If your child is on medication that prevents blood clotting (such as warfarin, heparin or aspirin)
- If your child is less than 2 years old
- If the nose bleed has been ongoing for more than 30 minutes despite appropriate first aid.
- If the nose bleed is from both nostrils (this suggests a nose bleed from the back of the nasal passageway)
- If despite sitting your child upright and getting them to lean forward, they are choking on the blood (this suggests a nose bleed from the back of the nasal passageway)
- If your child has significant disfigurement to their nose after injury to the face.
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone999
(first aid should be started simultaneously – see below)
If your child has any of the following:
- If there is a discharge from the nose alongside the nose bleed (as this may be due to a foreign body in the nose)
- If your child has frequent small volume nose bleeds that respond to first aid.
- If your child has nose bleeds and bruised skin anywhere on the body or a family history of a bleeding disorder
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If none of the above features are present:
Care using the advice below, can be provided to your child at home if none of the above features are present. If your child continues to get frequent nose bleeds, please arrange to speak to your GP or practice nurse.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.
Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
-
Shake the inhaler well and remove cap.
-
Fit the inhaler into the opening at the end of the spacer.
-
Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
-
Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10
-
Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines
Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
-
Shake the inhaler well and remove cap.
-
Fit the inhaler into the opening at the end of the spacer.
-
Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
-
Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10
-
Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines
- Keep your child well hydrated by offering them lots to drink
- Most children with coughs and colds do not require treatment with antibiotics.
- If your child seems to be in pain or discomfort, you can give your child Paracetamol or Ibuprofen, following the instructions on the container.
- Do not give cough syrup. It is not recommended for children under 6 years. It can make children sleepy and does not help.
- Try using saline nose drops or spray if your baby has a blocked nose.
- For children over 2 years, vapour rubs (containing camphor, menthol and/or eucalyptus) may help children sleep better.
Apply continuous pressure for 20 minutes to the fleshy front part of the nose by pinching it between index finger and thumb. Keep the child sitting up and leaning forward, breathing through their mouth (see diagram below). Encourage them not to swallow the blood but instead to spit it out, as swallowing blood can cause them to vomit which can then trigger the nose bleeding to restart.
Keep talking to your child with reassurance and keep them as calm as possible. It is tempting to release the pressure from the nose to check if the bleeding has stopped, but do not do so until the 20 minutes has finished. If there is ice available, then your child can also suck on some ice during this time or an ice-pack can be placed on their forehead or on the nape of their neck. Giving them a cool drink can also help them cool down.
If there is ongoing bleeding – recheck that the position of the pressure being applied is correct and apply pressure for a further 10 minutes
If at this point, there is ongoing bleeding then call an ambulance and calmly continue applying first aid measures until they arrive.
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features in amber, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations or if your child is showing any of the signs in the red section above.
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pages in this section
