Epistaxis on Warfarin

Author: Aleinmar Winthein / Editor: Yasmin Sultan / Reviewer: Thomas Bannister / Codes: / Published: 01/07/2021 / Reviewed: 06/01/2026

A 70-year-old woman attends the Emergency Department (ED) with ongoing epistaxis for the last 2 hours. She has a history of pulmonary embolism and is taking warfarin. She has been applying direct pressure to her nose for the last 30 minutes, with no improvement.

The examination shows profuse bleeding from both nostrils.

Her observations are:
RR 18, saturations 94% on air
HR 115 beats per minute
BP 105/65

You transfer her to the Resuscitation area and obtain iv access.

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