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Nosebleeds (epistaxis) in children are a common occurence. It is important when seeing a child with nosebleeds that a full history and careful examination should be udertaken. It is important that imporatant diagnosis such as a foreign body in the nose is excluded as well as any other serious pathology.

Commonly a small vein or an area of irritation from nose picking is the cause. It is quite common practice is to use naseptin ointment in the first instance. If it is evidently a small vein easily seen then it is sensible to cauterise this. It is very unusual to have to cauterise a childs nose under general anaesthesia this is most often done in the out-patient setting.

At home basic first aid should be employed. If this fails a child should be taken to the emergency department for further treatment and investigation

When an individual has a nosebleed (epistaxis), basic first aid is essential in the management. This includes the following

1. Lean the patient forward and encourage them to spit out any blood. Blood swallowed is hidden and causes significant stomach irritation.

2. Pinch the lower soft partof the nose firmly in order to cause compresssion for approximately 10 mins. There is no point putting pressure on the non compressible bony part of the nose as this has no effect and the majority of bleeding occurs lower in the softer cartilaginous part of the nose.

3. Sometimes an icepack on the bridge of the nose or on the nape of the neck is of some benefit.

If these measure fail then the patient should go to the emergency department for further treatment.