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Nosebleeds (Epistaxis), Pediatric

Bethlehem Abebe-Wolpaw, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Epistaxis: bleeding from the nostril, nasal cavity, or nasopharynx

  • Classified as either anterior or posterior

    • Anterior epistaxis is from the anterior nasal septum, usually is venous fr...

DIAGNOSIS

HISTORY

  • Frequency and duration

  • Laterality of the nosebleed

  • Local trauma (nose picking, foreign body)

  • Upper respiratory tract infection

  • Allergies

  • Obstruction

  • Discharge

  • Medications or drug use

    • NSAIDs, ...

TREATMENT

GENERAL MEASURES

  • Acute

    • Elevate the head forward.

    • Direct pressure, applied by gently squeezing the nostrils for 5 to 15 minutes, is usually sufficient to stop most nosebleeds.

    • Vasoconstricting ag...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Nosebleeds are easily controlled and self-limited in most cases.

  • Referral to an otorhinolaryngologist is indicated for patients with specific local abnormalities, ...

ADDITIONAL READING

  • Béquignon E, Teissier N, Gauthier A, et al. Emergency department care of childhood epistaxis. Emerg Med J.  2017;34(8):543–548. [View Abstract on OvidInsights]

  • Davies K, Batra K...

CODES

ICD9

784.7 Epistaxis 

ICD10

R04.0 Epistaxis 

SNOMED

  • 12441001 Epistaxis (disorder)

  • 232354002 Anterior epistaxis

  • 232355001 Posterior epistaxis

  • 232356000 Traumatic epistaxis

FAQ

  • Q: How should I explain to a child to stop a nosebleed that occurs at home?

  • A: The child or parent should apply pressure by compressing the lateral cartilaginous surface of the external nose togeth...

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