Epistaxis

Question 1

What is the epidemiology of epistaxis

Answer 1

bimodal age of onset
<10
and 45-65

Question 2

What are the 2 types of bleeds

Answer 2

Anterior - Kiesselbach’s plexus

Posterior - Sphenopalatine artery

Question 3

What is the dangers of posterior bleeding

Answer 3

blood at back of throat
continues even with anterior packing

higher risk of aspiration and airway compromise

Question 4

What are some common causes of epistaxis

Answer 4

idiopathic
nose-picking
trauma
age-related

Question 5

What are some uncommon causes of epistaxis

Answer 5

irritants
anticoagulants/ antiplatelets

Question 6

What are some rare causes of epistaxis

Answer 6

sinonasal neoplasm

coagulopathy

hereditary haemorrhagic telangiectasia

Question 7

What are some red flags of epistaxis

Answer 7

obstruction

serosanguinous discharge( thin and watery with red/pink hue)

take ABCDE approach

Question 8

What investigations do you do

Answer 8

Examine with thudicum nasal speculum +/- endoscopy

Question 9

What is the management for epistaxis

Answer 9

IV access and crystalloids for hypovolaemia

Hippocratic methods- lean forward and pinch anterior nares, hold for 20 minutes

Cauterise anterior point bleeds with silver nitrate

Anterior packing for multiple bleeds- refer to ENT for admission

Arterial ligation for unresolving bleeds