Epistaxis

Question 1

what are the causes of epistaxis?

Answer 1

Nose picking, Trauma, Idiopathic, Infection, Tumours, Hypertension, Anticoagulants, NSAIDs, Coagulopathy, Hereditary haemorrhagic telangiectasia, Allergies

Question 2

what is the anterior blood supply to the nose?

Answer 2

Kiesselbacks Plexus, (Little Area) = arterial plexus

Question 3

what is the posterior blood supply to the nose?

Answer 3

Woodruffs plexus = venous plexus

Question 4

what are the arteries that make up Kiesselbacks Plexus?

Answer 4

o	Anterior Ethmoid Artery
o	Posterior Ethmoid Artery
o	Sphenopalatine Artery
o	Great Palatine Artery
o	Superior Labial Artery

Question 5

what is the clinical features of the epistaxis?

Answer 5

blood drains from nostril?

Question 6

what is the 1st line management of epistaxis?

Answer 6

• Patient should lean forward + press fleshy part of nose (Hippocratic Manoeuvre)
• Ice pack to slow flow
• If this does not work silver nitrate

Question 7

what is the 2nd line management of epistaxis?

Answer 7

• Patient to blow out clots or use suction

* Apply a cotton ball soaked in adrenaline or local anaesthetic spray

Question 8

what is the 3rd line management of epistaxis?

Answer 8

• Find bleeding points – cauterise for 2 secs at a time (starting at sphenopalatine artery)

Question 9

what is the final management of epistaxis?

Answer 9

o Anterior nasal pack (Rhino pack)

o Postnasal Pack (Foley Catheter)