Abstract
Epistaxis, or nasal bleeding, occurs in over half of the general population. It is caused by various etiological factors and affects both sexes and all age groups. The simplest treatment for a nosebleed is pinching of the ala nasi, referred to as the Hippocratic technique. In this study, we adopted different treatment protocols dependent on the severity of bleeding and assessed the etiology and efficacy of these modalities. This was a prospective study. We recruited 25 patients (24 adults and 1 child) who presented with epistaxis in the ENT departments of two tertiary care hospitals. We evaluated the cause of epistaxis and efficacy of the treatments used. All patients had experienced several episodes of epistaxis and were managed using anterior nasal packing with gauze and ointment or with Merocel packs alone. The incidence of epistaxis was more common in males than in females. It was effectively managed by anterior nasal packing with Surgicel-wrapped Merocel. Patients did not experience further episodes of bleeding following the removal of Merocel and retention of Surgicel in place.
Highlights
Epistaxis is one of the most common ENT emergencies and has been reported in 60% of the general population [1]
Most patients can be treated within an emergency setting; some elderly patients may require more intensive treatments and hospital admission
McGarry [7] recently proposed a standardization of bleeding location, with bleeding anterior and posterior to the plane of the pyriform aperture classified as anterior and posterior epistaxis, respectively
Summary
Epistaxis is one of the most common ENT emergencies and has been reported in 60% of the general population [1]. McGarry [7] recently proposed a standardization of bleeding location, with bleeding anterior and posterior to the plane of the pyriform aperture classified as anterior and posterior epistaxis, respectively. It can be classified as primary or secondary when there is an underlying coagulopathy, such as in patients who are being treated with anticoagulant/antiplatelet medication. In such cases, the patients’ coagulation profile, blood count, blood grouping, and cross matching should be investigated. In cases of clotting factor deficiency and coagulopathies, the hemodynamic stability of the patient should be ensured with fluid replacement, electrolytes, and blood transfusion
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