Epistaxis

Question 1

Which group of patients do posterior haemorrhages occur in

Answer 1

Older patients and confer a higher risk of aspiration and airway compromise

Question 2

Causes of epistaxis

Answer 2

Nose picking and blowing, trauma, FB, bleeding disorders, juvenile angiofibroma, cocaine use, hereditary haemorrhagic telangiectasia and granulomatosis with polyangiitis

Question 3

First aid measures to controlling nose bleed

Answer 3

Sit forward with mouth open, pinching the soft area of the nose

Question 4

Measures if first aid techniques are successful

Answer 4

Topical anaesthetic such as Naseptin, self care advice and potential follow ups

Question 5

Measures if bleeding does not stop after 15 minutes

Answer 5

Cautery if bleed can be visualised. Packing if bleed is not visible

Question 6

What happens when epistaxis has failed all management

Answer 6

May require sphenopalatine ligation in theatre