Epistaxis
delightful.
| Headline | |
|---|---|
| Etiology | |
| Epidemiology | |
| Clinical presentation | Blood is emetogenic when swallowed |
| Pathogenesis | Most arise from Little's area |
| Diagnostic investigations | coag screen less useful unless there is a specific concern e.g. need for Anticoagulant reversal |
| Management | 1st line: Direct compression, ice pack 2nd line: packing, cautery if bleeding point can be identified Consider need for Impending bleeding doom stuff For all patients: analgesia Surgical intervention: sphenopalatine artery ligation |
Packs tend to stay in 24-48h{}
discharge advice
- not to blow, pick or otherwise traumatise their nose
- to avoid piping hot food and drink for a day
- to avoid strenuous activity or exercise for a day or two
- to apply antiseptic cream or soft paraffin to both nostrils twice a day for two weeks, taking care not to push fingers or nozzles right up into the nose (sniffing it up is safer)
- about first aid measures in case of a re-bleed
- to re-attend A&E if they have a nosebleed lasting longer than 20 minutes