Need advice quickly please. To go to A&E? Waiting for a call back from 111 - beginning to really panic *MNHQ content warning for blood*

[TheKhakiBee]

Hi, my daughter has been having a nosebleed for the past 20 minutes or so. Have tried everything to stop it, head forward, pinching the soft part of the nose continously. There is ALOT of blood. Waiting for 111 to call back. AIBU to A&E for this? I don't drive, don't know if a taxi would take us. Photo shows some of the blood.

Some of the advice here is pretty interesting.

www.nhs.uk/conditions/nosebleed/

1. For a nosebleed lean forwards and pinch the nose where it’s soft but as high as you can - PUT ON A 10 MINUTE TIMER and pinch consistently for at least as long as this
2. After 10-15 mins - which is a long long time you really need a timer - check, and if it’s still bleeding then pinch again; do this up to three times. If it’s still not stopped then minor injuries/a&e
3. Evidence for ice on the nose/back of neck etc etc is poor. Blood clots less well when it’s cold and you want to form a clot. Certainly don’t do any fannying around with ice instead of pinching.
4. Estimating blood loss is really hard, a little goes a long way. (Despite this the ambulance service do ask how much blood you’ve lost).
5. Ambulances do get called to nosebleeds; very occasionally this is necessary, mostly it isn’t.

Glad the bleeding stopped but sorry she has had another one this morning.

DS suffers from ridiculously heavy nosebleeds - like a tap at times. We have heard the "if it doesn't stop after 15 minutes go to A&E" (not heard to call an ambulance) which I think is based on them being able to cauterise. However I have always gone with assumption that it would stop by the time we arrived at A&E let alone waited to be seen.

We've used non-applicator tampons held underneath the nostril to collect blood - more absorbant than tissue and gives a comparison of how much blood is being lost to something parent would be familiar with. Really pinching the nostril hard in the fleshy bit (not the bony bit), sucking ice cube.

DS has had his nose cauterised (multiple times) it's a bit sore afterwards but not too bad and - fingers crossed - hasn't had a nosebleed in last 6 months.

Do follow up with GP and get a referral to ENT and blood tests to check for clotting. If you have a good children's A&E nearby it may be worth going in if she has another today as ENT appointment could take a while (6 months) to come through and the cauterization stick is very quick procedure.

Christ.. people are actually making posts about 'live' injuries - this is f'ing absurd

Exactly. I get that it’s distressing for the op but if she doesn’t drive then she should call a taxi - no way is this life threatening enough to merit an ambulance.

We once treated a woman who had been packed by the GP and told to call out of hours if it didn't stop.
She came in by ambulance and went straight to resus. It wasn't a positive outcome. I was only weeks into the job I've now been doing for 20 years. I have never seen that much blood since and I've been to many a major haemorrhage whilst working ED.

Whilst this child may not need an ambulance, there are certainly times when a nosebleed calls for one.

I (and my brother) had those growing up - really bad, lots of blood & clots, etc. Turned out there was a hole or something in a blood vessel, leading to more blood than usual. Had to get them cauterized to stop these kind of nose bleeds.

@TheKhakiBee

I would ring the surgery and ask for an on-the-day appointment, OP.

I am not a doctor.
But my daughter had a similar nosebleed -blood coming out of both nostrils, was difficult to stop it-, next morning she had small red dots on her hands and feet, + small bruises. It turned out to be idiopathic thrombocytopenic purpura, and she had extremely low platelets -blood wasn't coagulating-. We went straight to the GP who then sent us straight to hospital.
It's always worth getting it looked at. Hope your daughter is okay

My teacher had a sudden massive nose bleed, collapsed, was rushed to hospital and died.

Was a symptom of the massive aneurysm he had suffered.

Nose bleeds are very common in children and I'm sure OP doesn't have to worry that her DD brain hasn't 'popped' but uncontrollable bleeding is definitely an A&E issue and ambulance worthy. Uncontrolled bleeding from anywhere will trigger and emergency.

I used to get them as a child frequently and so did my DS, I reckon its an hereditary thing, I have a weak vein in my nose and so does my DS. I know it sounds silly but I do think its the change in atmospheric pressure that brings them on and affects how severe they are. Thats why I get them more in the summer. I called 999 once at night when they were particularly bad over 20 mins with my son and a paramedic came out and calmed my son down and it stopped quite soon after. Try not to worry and keep as calm as possible but do seek medical advice.

Are you seeking medical attention for dd?

It might be the change in weather. I get them at this time of year. I roll up 2 pieces of tissue or gauze, get her to blow out gently through her nose then insert them as far as I can and then pinch my nose hard with them in there, as close to the bony bit as I can. Hold for at least 20 seconds then remove, blow gently again and repeat. It usually works.

OP, how is your daughter now? I hope she got seen and is home and resting up. x

I used to get like this as a child, my tonsils and adenoids were putting too much pressure on the blood vessels so they had to be removed and had a few vessels cauterized while I waited. Hope she's OK this morning and the second bleed stopped quickly

I used to get massive nose bleeds as a child, had to have a blood vessel cauterised in the end. Not pleasant but fairly common I think x

My sister and I used to have epic nose bleeds. I remember pulling an 8 inch long clot out of my nostril after one that lasted a couple of hours😳My sister’s, though, were worse than mine - heavier and much more frequent. She had to have her nose cauterised a few times and it turned out she had a condition called Hereditary Haemorrhagic Telangiactasia. I’m certainly not suggesting that it is this, as there are other obvious symptoms of the condition in conjunction with the nosebleeds, but in general I think it’s always worth getting nosebleeds checked out if they become heavy, persistent and frequent. Mine became less frequent and heavy as I grew up, although I would say I’m still slightly more prone to them than the average person.

My husband had a posterior nosebleed which was so bad and couldn't be stopped, that he had to be blue lighted by ambulance to hospital.

Where we live in Perth Australia, if you call an ambulance, the paramedics decide if you need to go to hospital. They took one look at the three containers of blood and the blood in the toilet and all over the floor, and they said he had to go straight to ED.

He ended up being kept in hospital overnight and had a rapid rhino balloon put up his nose. The ENT surgeon saying with that amount of blood loss, you cannot leave it to chance.

Not all nosebleeds are minor.

We had to send my gran in by ambulance with a nosebleed that made her living room look like a murder scene. But she was a very frail 91 year old on blood thinners, not a mobile and otherwise healthy 7 year old, and that was 111's call not mine.
I would definitely be getting that sorted OP. She will probably need it cauterising.

Take her to A&E at a hospital, not to urgent care / walk-in at an outpost - a friend's daughter had exactly this experience last month and they brought down an ENT consultant who cauterised the nose on the same day.

My ds got a sudden nosebleed in PE (not caused by an impact) when he was 16 or so. It didn't stop and the teacher called an ambulance for him. We'd probably have driven him in if it had happened at home but I don't think it's automatically unreasonable to call an ambulance for a nosebleed.

Good advice if they are a regular occurrence.

Have you ever seen a taxi driver's reaction to your wanting to take someone seeping blood in their nice clean taxi?

How are things today op?

Hope your little one is doing ok

Bil got stabbed in the neck and taxi drove him to the hospital.

I think taxis can be good. Plus op just needs to hold tissues up, it won't spurt everywhere.

I’m sure OPs daughter will be fine and so are most bleeds.

For those doubting whether a nose bleed can be serious I have It is an inherited condition HHT or Osler Weber Rendu when blood vessels don’t form properly. It is called I would normally get a taxi (not keen on people bleeding in the car) or a friend. However it might need an ambulance.
My longest bleed was about 3 hours

if you have persistent heavy nose bleeds that are hard to stop please get checked as there are other potentially very serious symptoms. The recommended nosebleed treatment is also different.