Epistaxis

Question 1

Where do most epistaxis happen?

Answer 1

95% arise at Little’s area of the anterior septum, the location of the Kiesselbach plexus

Question 2

What are RF for epistaxis?

Answer 2

1. Dry weather
2. Nasal mucosal inflammation
3. Primary coagulopathy (haemophilia)
4. Minor trauma
5. Familila hereditary haemorrhagic telangiectasia
6. Medication
7. Neoplasm (rare)

Question 3

How common is epistaxis?

Answer 3

60% experience in lifetime, in young and old, drier times

Question 4

What are signs of symptoms of epistaxis?

Answer 4

Blood at one nostril or on both sides of nose

Question 5

What are possible differential diagnosis for epistaxis?

Answer 5

1. Haemoptysis

2. Haematemesis

Question 6

What invesitgations are used for epistaxis?

Answer 6

clinical diagnosis

Question 7

What is the management plan for epistaxis?

Answer 7

1. Firm pressure on both nostrils for 10 mins
2. Topical anaesthesia and vasoconstriction for initial treatment
3. Cautery or anterior or anterior-posterior packing techniques

Question 8

What are possible complications of epistaxis?

Answer 8

1. Acute bacterial rhinosinusitis
2. Septal perforation with bilateral cautery
3. Toxic shock syndrome
4. Cardiovascular compromise with extensive bleeding