What should you know about pediatric vomiting blood?

Blood may look bright red, dark brown or like coffee grounds. It can come from irritation or a tear in the throat or food pipe after forceful vomiting, swallowed blood from the nose or mouth, or bleeding in the stomach or upper intestine. Less common but serious causes include inflammation, an ulcer or another condition affecting the digestive tract. Oesophageal cancer and stomach cancer are possible medical conditions associated with upper digestive bleeding, but blood in vomit does not by itself establish a cancer diagnosis.

A clinician will ask about the amount and appearance, pain, dizziness, medicines and recent illness. Examination and tests help locate the bleeding and assess hydration and blood loss.

Keep the child sitting upright or on their side if drowsy. Do not give food, drink or medicines unless a clinician advises it, especially if urgent assessment is being arranged. Note the colour and approximate amount, keep a photo if safe, and bring a list of medicines and relevant medical history. Do not leave the child alone.

Seek emergency care immediately for repeated vomiting of blood, fainting, confusion, pale or clammy skin, severe abdominal pain, rapid breathing, black stools or inability to keep fluids down. Treat any blood in a child's vomit as urgent even when the child seems comfortable, because children can become unwell without much warning.

Ask where the bleeding may have started, whether tests or observation are needed, which medicines to stop or avoid, how to maintain hydration safely, and which changes require an immediate return to hospital.