Medical Insider – Dr. Ria P. Maslog

Epistaxis


Epistaxis is the medical term for nosebleeding. This is rare in infancy, common in childhood with a decrease in incidence after puberty.

Trauma is the most common cause of nosebleeding. 

In children, it is the picking of the nose and foreign bodies inside the nose which are the most identified cause of trauma. 

Some have family history of childhood epistaxis and there is increased likelihood during respiratory infections and in the winter when dry air irritates the nasal mucosa. 

Other causes of epistaxis includes the following: madenoidal hypertrophy, allergic rhinitis, sinusitis, polyps, and a variety of acute infections

Children with congenital vascular abnormalities and problems with clotting factors, hypertension, renal failure or venous congestion may also manifest epistaxis.

Clinically, epistaxis usually occurs without warning. 

The blood will flow slowly but freely from one nostril or occasionally from both. 

Some children, may swallow the blood and may become apparent when the child vomits or passes blood in his stools.

In most instances, nosebleeding stops spontaneously in a few minutes. In the event, that our children will have epistaxis, we should not panic. 

Here are some maneuvers that we should do:
– the nares should be compressed
– the child should be kept as quiet as possible
– the head can be tilted forward to avoid blood trickling posteriorly into the pharynx
– if epistaxis continues, in the presence of a physician or medical staff, a local application of a solution of neosynephrine may be useful
– or the insertion of an anterior nasal pack is done

Children with severe epistaxis or recurrent epistaxis should be referred for otolaryngologic evaluation. Also, if these children are living in a dry environment , they are advised the use of room humidifier to prevent epistaxis.