ABSTRACT
This chapter presents a case study of a 6-year-old boy who is admitted to the paediatric Emergency Department with a right-sided nosebleed. Epistaxis is common in children, affecting around half of children under 10 years of age. The bleeding most commonly derives from the anterior septum, known as Little's area. This is composed of an anastomosis of four arteries, namely, anterior ethmoid artery, sphenopalatine artery, greater palatine artery and the septal branch of the superior labial artery. Recurrent epistaxis in children can be due to chronic inflammation and crusting from Staphylococcus aureus colonisation of the nasal vestibule and mucosa. The history for epistaxis should elicit laterality, causative events like trauma, frequency and length of time, ease of bruising, medication use (especially anticoagulants) and family history of bleeding disorders. Examination of a nosebleed involves anterior rhinoscopy using an otoscope, which provides lighting and magnification.
