What happens after a telemedicine visit for Nosebleed (Epistaxis) - Triage

Audience: pediatric

After a telemedicine visit for a child's nosebleed (epistaxis), parents usually receive advice on how to care for the nose at home and when to seek further help. Most nosebleeds in children are not serious and can be managed with simple steps like applying gentle pressure and keeping the child calm. The healthcare provider may suggest ways to prevent future nosebleeds, such as keeping the child's nasal passages moist. If the bleeding stops and the child feels well, no immediate in-person visit is often needed. However, parents will be guided on warning signs that require urgent care. Follow-up may include monitoring the child's condition and possibly scheduling an in-person examination if bleeding recurs or other symptoms develop. Telemedicine helps quickly assess the situation and provide reassurance, but it does not replace hands-on medical evaluation when needed.

Red flags — go in person / ER

• Nosebleed lasting longer than 20 minutes despite applying firm pressure — seek emergency care immediately.
• Child feels weak, dizzy, or faint during or after the nosebleed — get urgent medical attention.
• Nosebleed follows a head injury or is accompanied by difficulty breathing — call emergency services right away.

What telemedicine can do

• Initial assessment of mild to moderate nosebleeds in children.
• Providing guidance on first aid and home care for nosebleeds.
• Advice on preventing future nosebleeds and when to seek further care.

What telemedicine cannot do

• Severe or uncontrolled bleeding requiring physical intervention.
• Nosebleeds associated with significant trauma or other serious symptoms.
• Performing physical examination or nasal packing procedures.

What to Expect After Your Telemedicine Visit

After the telemedicine visit, you will likely receive clear instructions on how to manage your child's nosebleed at home. This may include applying gentle pressure to the nose, keeping the child calm, and avoiding nose picking or blowing. The provider may also discuss ways to keep the nasal passages moist, such as using saline sprays or humidifiers.

When to Watch Closely

You will be advised to watch for signs that the nosebleed is not improving or is getting worse. If bleeding continues for more than 20 minutes despite first aid, or if the child feels weak, dizzy, or has trouble breathing, you should seek in-person emergency care immediately.

Preventing Future Nosebleeds

The healthcare provider may suggest preventive steps like using saline nasal sprays, applying a thin layer of petroleum jelly inside the nostrils, and keeping the child's environment humidified. Avoiding trauma to the nose is also important.

Follow-Up Care

If the nosebleeds are frequent or severe, the provider may recommend an in-person visit to check for underlying causes. Follow-up appointments can help ensure the child's safety and address any concerns.

Limitations of Telemedicine for Nosebleeds

While telemedicine is helpful for initial assessment and guidance, it cannot perform physical examinations or procedures. If the nosebleed is severe or accompanied by other symptoms, an in-person evaluation is necessary.

How to prepare for your tele-visit

• Have a list of your child's symptoms ready, including when the nosebleed started and how long it lasted.
• Prepare to describe any recent injuries, medications, or medical conditions your child has.
• Ensure good lighting and a quiet environment for the telemedicine visit.
• Have a flashlight or phone light available to show inside the child's nose if asked.
• Be ready to provide your contact information and emergency contacts.
• Have basic first aid supplies nearby, such as tissues or clean cloths.

After your tele-visit

• Apply gentle pressure to the child's nose as instructed during the visit.
• Keep the child calm and seated with head slightly forward to reduce blood flow to the nose.
• Use saline sprays or humidifiers to keep nasal passages moist if recommended.
• Monitor the child closely for any worsening symptoms or prolonged bleeding.
• Follow any specific instructions provided by the healthcare provider.
• Schedule an in-person follow-up if advised or if nosebleeds recur frequently.

FAQs

What should I do if my child's nosebleed starts again after the telemedicine visit?

Try applying gentle pressure to the soft part of the nose for 10 to 20 minutes without releasing. Keep your child calm and seated with their head slightly forward. If the bleeding does not stop after 20 minutes, seek in-person medical care immediately.

Can nosebleeds be a sign of something serious in children?

Most nosebleeds in children are harmless and caused by dry air, nose picking, or minor injuries. However, frequent or very heavy nosebleeds may require further evaluation by a healthcare provider to rule out underlying issues.

Is it safe to use nasal sprays or ointments to prevent nosebleeds?

Yes, saline nasal sprays and applying a small amount of petroleum jelly inside the nostrils can help keep the nasal lining moist and reduce nosebleeds. Always follow your healthcare provider's recommendations.

When should I take my child to the emergency room for a nosebleed?

Go to the emergency room if the nosebleed lasts more than 20 minutes despite applying pressure, if your child feels weak or dizzy, if the bleeding follows a head injury, or if your child has difficulty breathing.

Sources

1. Epistaxis (Nosebleed) — MedlinePlus, U.S. National Library of Medicine.
2. Nosebleeds (Epistaxis) in Children — American Academy of Pediatrics.
3. Nosebleeds — Mayo Clinic.
4. Epistaxis: Clinical Features and Management — National Library of Medicine.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical care, diagnosis, or treatment. If your child’s symptoms worsen or you have concerns, seek care from a healthcare professional in person or emergency services as needed.