Anterior Epistaxis Flashcards
What is the typical history associated with anterior epistaxis?
Sudden onset of nosebleed from one nostril. History of nasal trauma, dry air exposure, or use of nasal sprays. Possible recurrent episodes.
What are the key physical examination findings in anterior epistaxis?
Active bleeding from the anterior part of the nasal septum (Kiesselbach’s plexus). Visible source of bleeding on anterior rhinoscopy.
What investigations are necessary for diagnosing anterior epistaxis?
Clinical diagnosis based on history and physical exam. Nasal endoscopy if bleeding source is not visible. Blood tests (CBC, coagulation profile) if bleeding is severe or recurrent.
What are the non-pharmacological management strategies for anterior epistaxis?
Pinch the nostrils together for 10-15 minutes. Apply a cold compress to the nose or face. Humidify living spaces to prevent dry nasal passages.
What are the pharmacological management options for anterior epistaxis?
Topical vasoconstrictors (e.g., oxymetazoline) to control bleeding. Cauterization with silver nitrate for persistent bleeding. Nasal packing if bleeding does not stop with conservative measures.
What are the red flags to look for in anterior epistaxis patients?
Severe or persistent bleeding despite initial treatment. Signs of significant blood loss: dizziness, pallor. Recurrent epistaxis with no clear cause.
When should a patient with anterior epistaxis be referred to a specialist?
Refractory or severe epistaxis not responding to conservative management. Suspected posterior epistaxis or underlying coagulopathy. Need for advanced diagnostic evaluation or surgical intervention.
What is one key piece of pathophysiology related to anterior epistaxis?
Bleeding from the anterior part of the nasal septum, typically from Kiesselbach’s plexus. Can be caused by trauma, dry air, or irritation. Often self-limiting but can require medical intervention if persistent.
