Dear Readers,

Joanne, a young mother from Stony Hill, St Andrew, wrote Lifeline. Her concern is for her four-year-old son J, who has nasal allergies and tends to pick his nose a lot.

Joanne thinks this is the cause of his frequent nosebleeds as the paediatrician said that all the blood tests done are normal and J doesn't have any bad-blood disease.

Joanne asked Lifeline how to prevent nosebleeds as they are frightening, a lot of blood is lost and everyone gets scared. His bigger sister even cries when it happens!

The really small blood vessels which are located in the nasal septum (the tissue which separates the nostrils) are very fragile and very superficial. They tend to bleed very easily if irritated or if they become inflamed, as is the situation under the conditions of:

Nasal infection

Nasal injury

Nose picking

Nasal allergies

Foreign body to the nose

Forceful sneezing

Nosebleeds (epistaxis) will also occur frequently in a person or when the humidity is dry and, in turn, dries on the nasal mucosa. resulting in cracking of the nasal tissues and a resultant bleed as blood vessels are torn. This is a common cause of nosebleeds. Other causes of nosebleeds which are more serious are:

High blood pressures

Use of blood-thinning medications

Alcohol abuse

Blood cancers (Leukaemia)

Bleeding disorders

Tumours

Nosebleeds commonly occur in children and are usually not serious. There are measures which can be taken to stop a nosebleed when it occur. However, any nosebleed which seems to be recurring with frequency, prolonged or overly heavy, should merit a visit to the physician for further evaluation. In children. Often nosebleeds tend to involve only one side of the nose (one nostril).

Symptoms of a nosebleed will include:

Bleeding from one or both nostrils

Metal-tasting flow of liquid at the back of the throat

Urge to swallow frequently

The most common causes of nosebleeds are from the drying out of the nasal mucosa and from picking the nose. These situations can be avoided by keeping the nasal mucosa well lubricated by applying an ointment, even lubricating jelly can be used, or an antibiotic ointment which should be applied to the inside of the nose, especially over the middle nasal septum. A saline nasal spray is also useful.

When a nosebleed occurs, the following steps should be taken:

Calm the affected individual, especially if it's a child. Crying increases the flow of blood.

Have the person sit upright and bend their head over forward.

Squeeze the soft part of the nose between the thumb and index finger for 10 minutes.

Encourage the individual to breathe through their mouth.

After 10 minutes, release the pressure on the nostrils and check if bleeding has stopped.

If bleeding has slowed, but not fully stopped, re-apply nasal pressure and repeat the process, no more than a few times.

Sit quietly keeping the head at a level above the heart.

Apply ice to the nose and cheeks.

If bleeding persists after, seek the help of a physician or hospital emergency department.

Most nosebleeds can be stopped at home using the above detailed procedure. When Ppysician help is sought, the doctor may apply nasal packs to the nostrils, which may contain medication to constrict the nasal blood vessels.

To prevent nosebleeds:

Do not blow the nose hard when having a cold

Do not place any objects in the nose

Do not strain the body and increase the pressure in the blood vessels by straining to pass stool or straining to lift heavy weights.

Avoid smoking.

Do not use blood-thinning medications such as aspirin, Advil, Aleve or any non-steroidal-anti inflammatory drugs, Plavix or Warfarin.

After a nosebleed, do not blow out any clot material formed. Nasal drops and gels like Afrin and Otrivin, which contain preparations which constrict blood vessels, may be useful in controlling a nosebleed.

Avoid hot liquids for 24 hours after a nose bleed.

If there is a nasal infection, the application of a topical antibiotic to the inner nasal mucosa may lessen the frequency of nosebleeds.

In some individuals, who experience frequent nosebleeds, a specialist, ear nose and throat Surgeon may be able to cauterise the blood vessel which is causing the problem in the nostril.

If nosebleeds keep recurring with abnormal frequency, an examination, tests and assessment must be made by a physician.

Write to: Lifeline,

PO Box 1731,

AJM

KGN 8