What is the first step to take when managing a case of epistaxis in a child?

The first step in managing a case of epistaxis, or nosebleed, in a child is to sit the child upright and pinch the nose. This position helps to prevent blood from flowing down the throat, which can cause choking or nausea. Keeping the child upright ensures that gravity aids in reducing blood flow from the nasal vessels and allows for easier management of the bleeding.

Pinching the nose works by applying pressure to the soft part of the nose, which can help to constrict the blood vessels and ultimately stop the bleeding more effectively. This immediate action is crucial in managing the situation appropriately and alleviating potential complications.

In contrast, laying the child down flat would likely increase the risk of blood running down the throat, while applying ice directly to the forehead is less effective in controlling the specific problem of nasal bleeding. Using a cotton swab to clean the nose is not advisable during an active episode of epistaxis as it can exacerbate bleeding rather than help stop it.