The boss’s children are on onboard the yacht for a week of fun in the sun. Suddenly, one child starts to cry and runs toward you with a bloody nose.
Typically, the treatment for this is simple, yet most people get it wrong. What would you do? Would you hold the child’s head back or forward? Would you make the child blow his nose or not? Read below to get the correct first aid treatment for a nosebleed.
Nosebleeds are common in children and young adults. At this young age, they are most often a minor problem and not a medical emergency. However, if the bleeding does not stop, it could be a more serious problem.
In children and young adults, nosebleeds typically begin inside the septum, the piece of tissue that separates your nostrils. (In middle-age and older adults, nosebleeds can start in the septum or deeper inside the nose. If it is the latter, care must be taken as this could be a sign of more serious medical problems such as infection, high blood pressure or atherosclerosis, which is a hardening of the arteries. As always, when in doubt, get professional medical advice. Either visit a doctor or clinic or, if at sea, contact your telemedicine provider for advice.)
OK, so what do you do when a child comes to you with a nosebleed. Remember when your mother told you to hold your head back when you had a bloody nose? Well, Mom was wrong.
The correct steps to treating a bloody nose are as follows:
1. Sit down and lean slightly forward. When you do this, it prevents blood from going down your throat, which can cause irritation and possible nausea. Sitting this way also reduces the blood pressure inside the nose. Lower blood pressure means less bleeding. Make sure the head is kept above the level of the heart. Doing so also helps reduce bleeding.
2. Apply a clean tissue or washcloth under the nose, against the nostrils. This will help to reduce bleeding. Do not let the child sniff, pick or blow his nose.
3. With your thumb and index finger, gently but firmly pinch the nose just below the bone near the face and squeeze the nostrils shut for 5-10 minutes. By squeezing the septum, we can usually stop the bleeding. Apply continuous pressure for at least 5 minutes before letting go.
4. Replace the tissue or washcloth with a clean one if the bleeding has not stopped.
5. Have a bucket or glass handy to encourage the child to spit out any blood that seeps into his mouth to prevent him from swallowing it. Again, do not permit the child to sniff, pick or blow his nose.
6. After 5 minutes of constant pressure, slowly remove the tissue or washcloth. If the nose is still bleeding, apply pressure to the nose by gently but firmly pinching the nostrils closed for another 5 minutes.
7. When the bleeding stops, wash away any blood with warm water. Again, do not let the child sniff, pick or blow his nose for several hours. Doing so may cause the nose to bleed again. The child should avoid any activity for a few hours as this, too, could re-start the bleeding.
If the bleeding does not stop after more than 20 minutes of pressure, seek more advanced medical advice. The Mayo Clinic recommends immediate medical care when the nosebleed follows an accident, a fall or an injury to the head, including a punch in the face that may have broken the nose.
I would seek medical care if the patient is weak, is taking blood thinners such as warfarin (Coumadin) or aspirin, has a bleeding disorder, is pale, or has a blood pressure or pulse that is not within normal ranges. Remember the golden rule: When in doubt, call for help and get advice from a doctor.
People taking blood thinners such as aspirin or Coumadin may experience more bleeding and more difficulty clotting.
For injuries requiring medical treatment, a doctor may use specialized cotton material, insert a balloon in the nose, or use a special electrical tool to cauterize the blood vessels. If the nose is broken, generally these are not fixed immediately.
Remember to protect yourself when helping others who are bleeding. My advice: If something is icky, sticky or wet and not from your body, wear gloves and eye protection.
Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or www.TheCPRSchool.com. Comments on this column are welcome at firstname.lastname@example.org.