Epistaxis

Question 1

Most common location of bleeding in epistaxis?

Answer 1

Little’s area

Question 2

How to ask patient to self treat a nosebleed?

Answer 2

Lean forward
Pinch soft part of nose together for 10-15 mins
Breath through mouth only
Spit out blood rather than swallow

Question 3

When do you require hospital admission for epistaxis?

Answer 3

If bleeding does not stop after 10-15 minutes

Bilateral epistaxis

Question 4

Management of epistaxis?

Answer 4

1st line - Conservative: advise patient on self managing it, topical antiseptic to prevent rebleeding

2nd line - If point of bleeding identified -> nasal cautery
If point of bleeding not identified, OR nasal cautery doesn’t work -> nasal packing
If posterior epistaxis -> posterior packng with Foley catheter and balloon

3rd line - If packing doesn’t work -> embolisation surgery