Acute Epistaxis

Authors: Jonathan D Whittaker / Editor: Tajek B Hassan / Reviewers: Shahzad Salim, Mohamed Elwakil, Ahmad Alabood / Code: O9 / Published: 12/02/2012 / Reviewed: 12/06/2024

This module covers the assessment and management of epistaxis in the emergency department (ED).

After completing this session you will be able to:

  • Describe the pathophysiology of epistaxis
  • Itemise the essential components of first aid management
  • Outline initial patient assessment relevant to epistaxis
  • Describe nasal examination and basic management techniques used in the emergency department
  • Formulate an appropriate epistaxis investigation and management pathway

Please refer to the following web resource for more information:

emedicine.com – Epistaxis:

START MODULE

References

  1. Pallin DJ, Chng YM, McKay MP, Emond JA, Pelletier AJ, Camargo CA Jr. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med. 2005 Jul;46(1):77-81.
  2. O’Donnell M, Robertson G, McGarry GW. A new bipolar diathermy probe for the outpatient management of adult acute epistaxis. Clin Otolaryngol Allied Sci. 1999 Dec;24(6):537-41.
  3. Strachan D, England J. First-aid treatment of epistaxis–confirmation of widespread ignorance. Postgrad Med J. 1998 Feb;74(868):113-4. doi: 10.1136/pgmj.74.868.113.
  4. Lavy JA, Koay CB. First aid treatment of epistaxis–are the patients well informed? J Accid Emerg Med. 1996 May;13(3):193-5.
  5. Sauter TC, Hegazy K, Hautz WE, et al. Epistaxis in anticoagulated patients: Fewer hospital admissions and shorter hospital stays on rivaroxaban compared to phenprocoumon. Clin Otolaryngol. 2018 Feb;43(1):103-108.
  6. McGarry GW, Moulton C. The first aid management of epistaxis by accident and emergency department staff. Arch Emerg Med. 1993 Dec;10(4):298-300.
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  13. National Institute for Health and Care Excellence (NICE). Epistaxis (nosebleeds): What causes it? NICE CKS. Last revised: Dec 2022
  14. Turner P. The swimmer’s nose clip in epistaxis. J Accid Emerg Med. 1996 Mar;13(2):134. doi: 10.1136/emj.13.2.134.
  15. Teymoortash A, Sesterhenn A, et al. Efficacy of ice packs in the management of epistaxis. Clin Otolaryngol Allied Sci. 2003 Dec;28(6):545-7.
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  20. Carney AS, Weir J, Baldwin DL. Contamination with blood during management of epistaxis. BMJ. 1995 Oct 21;311(7012):1064. doi: 10.1136/bmj.311.7012.1064.
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