Epistaxis

Question 1

Where does bleeding usually occur

Answer 1

Originates from Kiesselbach’s plexus, which is located in Little’s area

Question 2

CLINICAL FEATURES

Presentations (triggers)

Answer 2

• Young children, triggered by
  
  • Nose picking
  • Colds
  • Sinusitis
  • Vigorous nose blowing
  • Trauma
  • Changes in weather
  • Snorting cocaine
  • Tumours
• Usually unilateral

Question 3

MANAGEMENT

General

Answer 3

• Usually without medical assistance
• Hospital admission if does not stop after 15 minutes, or is severe, bilateral or haemodynamically unstable

Question 4

MANAGEMENT

How to stop a nose bleed

Answer 4

1. Sit up and tilt head forward
2. Squeeze soft part of nostrils together for 10-15 minutes
3. Spit out any blood in mouth rather than swollowing

Question 5

MANAGEMENT

Treatment options after hospital admission

Answer 5

• Nasal packing using nasal tampons or inflatable packs
• Nasal cautery using silver nitrate sticks

Question 6

MANAGEMENT

Medication that can be prescribed after treating acute nosebleed

Answer 6

Naseptin (chlorhexidine and neomycin) 4x a day for 10 days to reduce any inflammation and infection