PLAB02-157

You work in a GP surgery and are asked by the receptionist to urgently see Toby who is 6 years old. He is having quite a severe nosebleed. He was brought in by his mother as they had been walking home from school when the nosebleed started and she was unable to stop it. Toby’s mother Lucy thinks he might have picked his nose.

On examination, Toby’s t-shirt is covered in blood and he has a blood-stained tissue pressed against his nose. He appears slightly distressed, but his observations are normal. You initiate simple first-aid measures and the bleeding stops. Lucy thinks the entire episode lasted approximately ten minutes. Toby is normally a well child and hasn’t had any episodes of epistaxis before.

What is the most appropriate next step?

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