Forums : Zdravlje

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Djecak od 3 godine, bronhitis + krvarenje iz nosa
nikraider
(Mesar)
2009-11-22 10:08 AM
Dobar dan,

Ukratko:

Djecak od 3 godine već sedmicu dana ima duboki kasalj.

U prva dva dana je povratio 2X. Nema temperaturu, dakle samo kasalj. Otisli smo kod doktora u četvrtak i dali su nam „bronchodilator for oral inhalation” (salbutamol HFA 100 mcg) i rekli kako ima viralni bronhitis. Dakle od četvrtka uzima/koristi pumpu. Jucer (subota) igrao se sasvim normalno u dnevnom boravku i od jednom mu je pocela da curi krv iz nosa. Nije iscurilo puno. Tokom noći(tj. jutros oko 3h00) jako se zakasljao, otisao sam da ga vidim i nasao sam ga u lokvi krvi (opet iz iste nosnice - lijeve). Dakle, krvario je is nosa 2X u zadnjih 20-tak sati.

Da dodam da sam i ja imao problema sa krvarenjem nosa sve do 7-8 godine, kad su mi u Vojnoj Bolnici u Sarajevu uzeli nekakvu zicu i „spalili” nos (to je bila doktorska terminologija). Moj sin je i prije imao problema sa krvarenjem nosa, ali smo od tada uzeli desudimifikator koji non-stop radi u njegovoj sobi.

Pokusao da budem sto precizniji - možda jeste malo dugo, al' kad je zdravlje djece u pitanju pokusavam navesti sve detalje, mozdacak i one nevažne za strucnjake.

Šta se desava? Šta raditi, šta ne raditi.

Nisam siguran da ima ikakve veze, ali samo da budem mirne duse navescu da je primio vakcinu protiv gripe (A)H1N1 prije 3 sedmice, nije bilo nikakvih komplikacija. Zamolio bih Vas da mi nepisete u stilu: „kakav si otac kad si vakcinisao svoju djecu”... itd...

Unaprijed zahvalan
Galeb
2009-11-22 10:51 AM
Na osnovu vasih podataka teško je znati šta je uzrok krvarenja a i mjesto gdje se krarenje javlja u nosu. Obzirom da može biti prednje i zadnje da uzroci mogu biti razliciti, potrebno je otici na pregled kod ORL koji će to rešiti.
Da razumete tezinu rešenja problema, navodim vam tekst koji o tome govori:
Nosebleeds up^
The nose is an area of the body that contains many tiny blood vessels or arterioles that can break easily. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 years. Nosebleeds are divided into two types, depending on whether the bleeding is coming from the front or back of the nose.
What is an anterior nosebleed?
Most nosebleeds or epistaxes begin in the lower part of the septum, the semi-rigid wall that separates the two nostrils of the nose. The septum contains blood vessels that can be broken by a blow to the nose or the edge of a sharp fingernail. Nosebleed coming from the front of the nose or anterior nosebleeds often begin with a flow of blood out one nostril when the patient is sitting or standing.
Anterior nosebleeds are common in dry climates or during the winter months when dry, heated indoor air dehydrates the nasal membranes. Dryness may result in crusting, cracking, and bleeding. This can be prevented by placing a light coating of petroleum jelly or an antibiotic ointment on the end of a fingertip and then rub it inside the nose, especially on the middle portion of the nose (the septum).
How to stop an anterior nosebleed?
1. Stay calm, or help a young child stay calm. A person who is agitated may bleed more profusely than someone who’s been reassured and supported.
2. Keep head higher than the level of the heart. Sit up.
3. Lean slightly forward so the blood won’t drain in the back of the throat.
4. Using the thumb and index finger, pinch all the soft parts of the nose or place a cotton ball soaked with Afrin, Neo-Synephrine, or Dura-Vent spray into the nostril and apply pressure. The area where pressure should be applied is located between the end of the nose and the hard, bony ridge that forms the bridge of the nose. Do not pack the inside of the nose with gauze or cotton.
5. Apply ice—crushed in a plastic bag or washcloth—to nose and cheeks.
6. Hold the position for five minutes. If it’s still bleeding, hold it again for an additional 10 minutes.
What is a posterior nosebleed?
More rarely, a nosebleed can begin high and deep within the nose and flow down the back of the mouth and throat even if the patient is sitting or standing.
Obviously, when lying down, even anterior (front of nasal cavity) nosebleeds may seem to flow toward the back of the throat especially if coughing or blowing the nose. It is important to try to make the distinction between the anterior and posterior nosebleed, since posterior nosebleeds are often more severe and almost always require a physician’s care. Posterior nosebleeds are more likely to occur in older people, persons with high blood pressure, and in cases of injury to the nose or face.
What are the causes of recurring nosebleeds?
* Allergies, infections, or dryness that cause itching and lead to picking of the nose.
* Vigorous nose blowing that ruptures superficial blood vessels.
* Clotting disorders that run in families or are due to medications.
* Drugs (such as anticoagulants or anti-inflammatories).
* Fractures of the nose or the base of the skull. Head injuries that cause nosebleeds should be regarded seriously.
* Hereditary hemorrhagic telangiectasia, a disorder involving a blood vessel growth similar to a birthmark in the back of the nose.
* Tumors, both malignant and nonmalignant, have to be considered, particularly in the older patient or in smokers.
When should an otolaryngologist be consulted?
If frequent nosebleeds are a problem, it is important to consult an otolaryngologist. An ear, nose, and throat specialist will carefully examine the nose using an endoscope, a tube with a light for seeing inside the nose, prior to making a treatment recommendation. Two of the most common treatments are cautery and packing the nose. Cautery is a technique in which the blood vessel is burned with an electric current, silver nitrate, or a laser. Sometimes, a doctor may just pack the nose with a special gauze or an inflatable latex balloon to put pressure on the blood vessel.

Tips to prevent a nosebleed
* Keep the lining of the nose moist by gently applying a light coating of petroleum jelly or an antibiotic ointment with a cotton swab three times daily, including at bedtime. Commonly used products include Bacitracin, A and D Ointment, Eucerin, Polysporin, and Vaseline.
* Keep children’s fingernails short to discourage nose picking.
* Counteract the effects of dry air by using a humidifier.
* Use a saline nasal spray to moisten dry nasal membranes.
* Quit smoking. Smoking dries out the nose and irritates it.
Tips to prevent rebleeding after initial bleeding has stopped
* Do not pick or blow nose.
* Do not strain or bend down to lift anything heavy.
* Keep head higher than the heart.
If rebleeding occurs:
* Attempt to clear nose of all blood clots.
* Spray nose four times in the bleeding nostril(s) with a decongestant spray such as Afrin or Neo-Synephrine.
* Repeat the steps to stop an anterior nosebleed.
* Call a doctor if bleeding persists after 30 minutes or if nosebleed occurs after an injury to the head.

Sve najbolje Galeb

nikraider
(TATA)
2009-11-22 11:13 AM
Dragi Galebe,

Veliko Vam hvala na brzom odgovoru! De mi recite što se tiče kaslja, koliko viralni bronhitis može da traje? Pravo da Vam kažem, ne ide mi se kod doktora (cekat ćemo 3-4 sata u cekaonici punoj bakterija...) ali ako se mora onda se mora. Nadam se da me razumijete.

Unaprijed zahvalan!!!
Galeb
2009-11-22 11:48 AM
Kada je u pitanju odlazak kod doktora, vi trebate da odvedete dijete kod ORL a oni obično nemaju febrilnih pacijenata. Famili doktor ne moze vrsiti pregled straznjeg dijela nosnih supljina.
Kada je u pitanju kasalj kod djece koji je uzrokovan virusom, tu je duzina kaslja vezana za viru koji je do kaslja doveo i opsteg imunoloskog stanja djeteta. Od istog virusa jedno dijete nema kaslja a drugo zna vuci kasalj nekoliko nedelja. Isto tako kod nekih viroza kasalj traje dva do tri dana a kod nekih nekoliko nedelja.
Na vase pitanje ne bih mogao dati tocan odgovor.
Sve najbolje Galeb
nikraider
(TATA)
2009-11-22 11:54 AM
VELIKO VAM HVALA!!!
ahha
(nemam)
2009-11-22 12:01 PM
U vezi krvarenja iz nosa:dali mu dajes kapljice za nos? Ako dajes moglo bi to biti uzrok.
U vezi vakcine:ti si odlucio da vakcinises dijete jer želiš da ga zastitis od virusa.
To sto je mišljenje oko vakcine vrlo razlicita ( i ljekari su protivrjecni) samo izluđuje roditelje.
Nadam se da će dijete biti uskoro vrlo dobro.
kokokokokokoda
(kuvarica)
2009-11-22 12:44 PM
moje dete ima 4 god..trenutno ima bronhitis i na početku bolesti mu je krenula krv iz nosa dva puta
ja krvarenje iz nosa povezujem sa padom imuniteta..chim pochne krvarenje..već mi je jasno shta će se desavati sledećih dana...
dana28
2009-11-22 12:48 PM
Pre dve godine gledala sam emisiju o bebama i deci koja su imala krvarenje iz nosa po mesec i vise dana
i na kraju utvrdjeno je da su izazivale neke čestice u vazduhu tipa da li su spore šta li već od budji vlage koju su najcesce nalazili u podrumima njihovih kuca čak se desavalo da se ne vidi pa su je pronalazili iza nekih već pregradjenih zidova ili nekog namestaja
ispostavilo se da izazivaju plucnu bolest kod dece koja je opasna
možda nema nikakve veze sa vasim problemom ali setila sam se tog dokumentarca
pozdrav
pravda_i_istina
2009-11-22 02:47 PM
desudimifikator - ja probao da izguglam i ništa..
da nije humidifier - ovlazivac prostorije? grejanje susi vazduh, pa treba malo da se ovlazi, a malo i da se smanji grejanje, bar nocu...

inače, svakom detetu podje krv na nos, a ja moje ucim da jede vise juznog voca, jagoda, pije limunadu, jel bioflavonoidi jacaju te „sitne krvne sudove”, a tako jacamo i imunitet generalno
nikraider
(TATA)
2009-11-22 03:54 PM
Grijanje nam je na toplu vodu - tako da zrak i nije suh. A ovo sto smo uzeli, ljeti skida vlagu a zimi (radi grijanja) ima kontra efekt.
ahha
(nemam)
2009-11-23 12:32 AM
Dok san zivjela u kuci igrijali se na drva sve mi je bilo u redu s sluznicom nosa. Kada je krenulo centralno grijanje poceo mi je nos krvariti i imal sm osjecaj da mi je sluznica nosa suha.
pravda_i_istina
2009-11-23 08:29 PM
upravo zato zimi treba da rade ti humidifier-i/ovlazivaci, koji su u sustini jednostavni, rezervoar vode i ventilator, ... mi nas još nismo startovali, jer su nam prozori/terasa još uvek vise otvoreni nego zatvoreni, a takođe i ventil za centralno, još uvek nema mraza napolju
aleksvasicaleks
(cool)
2009-12-06 09:30 PM
za sve probleme koje navodite, ja vam mogu preporuciti najboljeg ORL doktora u Beogradu a obisao sam ih mnogo posto probleme sa usima imaju moji klinci, sa sinusima ja a sa grlom moja supruga. Presrecni smo sto smo ga pronasli jer nas je sve za vrlo kratko vreme izlecio nakon mnogo mnogo orl doktora. Dr Miloš Švraka ima specijalističku ordinaciju ORL MEDIC na Vidikovcu, ul. Vidikovacki venac 80v, tel 011/065 234 23 81, cene su sasvim prihvatljive a njegovo ogromno znanje i iskustvo su mnogima već pomogli. Toplo vam preporucujem doktora. Srećno...
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