Q: My child is hospitalized for pneumonia and had a massive nosebleed after severe coughing. Is it from the pressure?
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My child is currently hospitalized for pneumonia. They slept deeply without coughing, but as soon as they woke up in the morning, they started coughing uncontrollably and had a massive nosebleed. Could the nosebleed be caused by the pressure from the intense coughing?
Answer:
It must have been very frightening to see your child have a sudden, heavy nosebleed while in the hospital.
[What to do right now]
Have your child sit up or elevate their upper body, and tilt their head slightly forward.
Pinch the soft part of the nose (just above the nostrils) firmly with your thumb and index finger and hold it for 10 continuous minutes.
Have your child breathe through their mouth. Tell them to spit out any blood in their mouth rather than swallowing it.
If the bleeding continues after 10 minutes of continuous pressure, notify the ward nurse or the doctor on duty immediately.
[Why the nosebleed happened]
For a child hospitalized with pneumonia, a nosebleed can happen for a few overlapping reasons:
Severe coughing forces a sudden spike in pressure within the delicate blood vessels of the nasal mucosa, which can cause them to rupture.
Dry hospital air, especially if the child is receiving oxygen therapy, can severely dry out the nasal lining.
Active inflammation and fever can temporarily weaken the blood vessels, making them more prone to bleeding.
[When to alert the medical staff immediately]
Call the nurse right away if any of the following occur:
The bleeding does not stop after 10 minutes of proper pressure.
The amount of blood is unusually large (e.g., more than half a cup).
The child vomits blood or is swallowing large amounts of it.
The child becomes excessively pale or complains of dizziness.
The child shows signs of difficulty breathing.
[Prevention during hospitalization]
Try to maintain the room's humidity between 40-60% (you can use a humidifier if permitted, or hang wet towels).
Use a gentle saline nasal spray 3 to 4 times a day to keep the nasal passages moist.
Keep your child's fingernails short to prevent them from picking at dry scabs in their nose.
Encourage your child to open their mouth slightly when they cough to help diffuse the pressure buildup in their head.
Please start with 10 minutes of direct pressure on the nose. If the bleeding is heavy, persistent, or if you are concerned, do not hesitate to press the call button to have the ward's medical team evaluate your child right away.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
