When Your Child Should See a Pediatrician About Nosebleeds
The Doc Smitty talks treatment and when surgery may be needed
Carter Guidry has seen more than his fair share of doctor’s office and been through multiple procedures and treatments because of his history of low antibody levels, resulting in frequent infections. But nothing prepared his family for what happened a few weeks ago.
The 8 year old woke up in the middle of the night with a nosebleed that lasted 20 minutes. After drenching the bed and several towels, Casey, Carter’s mom, became concerned. Carter tried his best to calm his mom by saying, “I’m going to be Ok mom. It’s going to be OK.” During the nosebleed, Carter became progressively weak , seemed very pale and was complaining of vision changes like he was about to pass out.
Casey called 911, worried that something bad might happen before she could get help. Fortunately, while the first responders were on their way, the nosebleed slowed and Carter started to get back to normal but Casey still needed some reassurance that things would truly be OK.
I saw Carter soon after that night. As we talked, it became clear that, while had a history of nosebleeds, things were worsening in both how often they were occurring and how severely his nose was bleeding. We decided to keep a close eye on him and monitor when the nosebleeds were happening. Later in the week, she contacted me to let me know that his nose had bled for over an hour the previous night. During this nose bleed, he didn’t have any of the other more scary symptoms, but we both felt it was time to get him some more help.
Fortunately Natalie Roberge, M.D., one of Cook Children’s Ear Nose and Throat doctors was able to see Carter the next day. Dr. Roberge described what she discovered, “His nose bleeds were unusual because they lasted so long (up to 1-2 hours), and blood would also come out his mouth when he pinched his nose.”
The day following his appointment, Carter was scheduled for a surgery in which she “cauterized a little artery on each side of his nose to seal up the blood vessel and prevent bleeding.” He did very well with his procedure and has had no further nosebleeds since.
Nosebleeds are very common this time of year and it’s very unusual for children to require a procedure to help control nosebleeds. The blood usually comes from dry, cracked skin and fragile vessels in the nose especially in dry seasons. Even minor trauma like nose picking can cause significant bleeding.
Most nosebleeds can be controlled by applying pressure to the bridge of the nose for 5 minutes (and don’t check every 10 seconds). You can prevent nosebleeds by applying some nasal saline or Vaseline to the nose at night time, especially during dry seasons.
Dr. Roberge states that parents should “seek care for nosebleeds lasting more than 10 minutes, when the amount of blood is concerning (more than a quarter cup), more than twice a week or associated with other concerning symptoms.”
Justin Smith is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Ft. Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in the spring of 2017.