Epistaxis

Question 1

What area is associated with anterior bleeds?

Answer 1

Little’s area - Kiesselbach’s plexus

Question 2

What area is associated with posterior bleeds?

Answer 2

Woodruff’s plexus

Question 3

What is the management for epistaxis?

Answer 3

First aid:
Sit forward and pinch cartilaginous part of nose

If 1st aid successful, consider using Naseptin to reduce crusting and risk of vestibulitis

Naseptin = chlorhexidine and neomycin. It contains peanuts so check for allergy

If bleeding continuing after 10-15mins :
Find the vessel causing bleed then perform silver nitrate cautery
If can’t find vessel then do anterior nasal packing
If posterior bleed, perform posterior nasal packing for 48hrs. If >48hrs, prescribe abx for prophylaxis
If bleeding continues, ligate artery causing the bleeding, most commonly sphenopalatine and anterior ethmoidal arteries

After cautery, give naseptin