Acute and Emergency

Question 1

What is epistaxis?

Answer 1

Nosebleeds

Usually from the Kisselbach plexus in Little’s area. An area of nasal mucosa that contains lots of blood vessels. When the mucosa becomes disrupted, the blood vessels are exposed.

Question 2

What can cause epistaxis?

Answer 2

Nose-picking
Colds
Sinusitis
Vigorous nose-blowing
Trauma
Changes to weather
Coagulation disorder
Anticoagulation medication
Snorting
Tumours

Question 3

How does epistaxis present?

Answer 3

Unilateral bleeding from nostril

Bilateral bleeding may indicate issue posterior to the nose and a higher risk of aspiration of blood

Question 4

How is epistaxis managed?

Answer 4

Usually resolve on own

Recurrent and significant nosebleeds

Recurrent and significant ones need further investigation to look for thrombocytopenia or clotting disorder

1. Sit up and tilt head forwards
2. Squeeze the soft part of the nostrils for 10-15 mins
3. Spit out any blood in the mouth, rather than swallowing
4. If keeps going on then go to hospital
5. Nasal packing and nasal cautery (tampons or silver nitrate sticks)

Consider Naseptin nasal cream 4 times daily for 10 days to reduce and inflammation and infection unless they have a peanut or soya allergy

Question 5

What is an abdominal aortic aneurysm?

Answer 5

Dilation of the abdominal aorta with a diameter of more than 3cm.