Epistaxis

Question 1

Relevant PMH of epistaxis

Answer 1

Anticoagulation
Liver disease
Fracture
Tumour
Previous surgery
Aspirin and NSAID
ANTIPLATELETS
COAGULOPATHY
PERFORATION

Question 2

Mx of epistaxis

Answer 2

1. Direct compression - sitting and leaning forward for 10-15min
2. Cautery (apply topical nasal spray and vasoconstrictor –> lidocaine with phenylephrine)
   - Chemical - silver nitrate sticks
   - Electrical (thermal)
   Nasaseptin for for 10 days
3. Nasal packing - Nasal tampons, inflatable packs and ribbon gauze impregnated with Vaseline
4. Posterior bleed refractory to previous options: Nasal balloon catheter or transnasal endoscopy