Epistaxis Flashcards
Where does bleeding usually originate in nosebleeds?
Kiesselbach’s plexus, located in Little’s area
List three common aetiologies of nosebleeds.
- Nose picking
- Colds, sinusitis
- Vigorous nose-blowing
Name two coagulation disorders that can cause nosebleeds.
- Thrombocytopenia
- Von Willebrand’s disease
What are two substances that can increase the risk of nosebleeds?
- Anticoagulants
- Antiplatelets
What might bilateral nostril bleeding indicate in epistaxis?
Posterior bleed, higher risk aspiration
What does vomiting blood indicate in the context of nosebleeds?
Swallowing of blood
What is the initial management advice for a nosebleed?
- Sit up and tilt head forwards
- Squeeze soft part of nostrils for 10-15 minutes
- Spit out any blood in the mouth
When should secondary care management be considered for a nosebleed?
- Bleeding not stopped after 10-15 minutes
- Severe nosebleed
- Bleeding bilaterally from both nostrils
- Haemodynamically unstable
What are two secondary care treatments for nosebleeds?
- Nasal packing (nasal tampons or inflatable packs)
- Nasal cautery (silver nitrate sticks)
What is an option for post-epistaxis management?
Naseptin nasal cream.
Contains chlorhexidine and neomycin.
Applied 4x daily for 10 days.
What is a contraindication for using naseptin nasal cream?
Peanut and soya allergy
How to manage epistaxis that has not resolved with emergency treatment including packing +/- cautery?
Ligation of sphenopalatine artery in theatre
