Nosebleed (Epistaxis) Pediatric Care Plan

By David Shafran, MD
Medically reviewed
February 9, 2021

Epistaxis refers to nosebleeds, which are very common in children and usually not a sign of something more serious. Bleeding typically occurs from a network of blood vessels located on the nasal septum, the dividing ‘wall’ between the nostrils. Because the layer of skin covering these blood vessels is so thin, bleeding can occur pretty easily. Once bleeding happens once, it tends to recur.

Common causes and contributors to nose bleeding include:

  • Nose picking
  • Trauma
  • Foreign body 
  • Allergies
  • Upper respiratory infections

In rare circumstances, nosebleeds that are frequent or excessive can indicate something more serious.

Epistaxis Diagnosis & Treatment

Diagnosis of epistaxis can almost always be made based on a good history and physical exam. 

Treatment of nosebleeds (one time or recurring) will involve:

Stopping the bleeding 

  • Apply direct compression to the lower 3rd of nose for a minimum of 5 straight minutes with your child sitting up and bent forward at the waist.
  • Do not lean your child’s head backwards as this might cause them to vomit.

Preventing recurrence 

  • Apply vaseline with a cue tip to the inner wall of the nose 
  • Humidify your childs room 
  • Gently irrigate their nostrils with normal saline drops 
  • Treat underlying allergies if appropriate

Check in With K If…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a Doctor In Person If…

  • There is severe or persistent bleeding
  • There is a family history of bleeding disorders
  • Your child shows other signs of bleeding such as easy bruising or bleeding gums
  • Your child feels lightheaded or dizzy
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.