Epistaxsis

Question 1

where does bleeding in epistaxis usually originate from

Answer 1

Kiessebachs plexus

-which is located in Littles area

Question 2

define littles area

Answer 2

area of nasal mucosa at the front of the nasal cavity that contains lots of blood vessels

-if the mucos is disrupted and blood vessels exposed this can bleed

Question 3

what can trigger a nosebleed

Answer 3

nose picking

cold

sinusitis

vigorous nose-blwoing

trauma

changes in the weather

coagulaton disorders eg thrombocytopenia or VWD

anticoag meds

snorting cocaine

tumours

Question 4

how can patients with epistaxis present

Answer 4

pateints that swallow blood can present with vomiting blood

usually unilateral

if bleeding from BOTH nostrils
-may indicate bleeding posteriorly in the nose
-they are at a higher risk of aspriation of blood

Question 5

management of epistaxis

Answer 5

usuallt resolve spontaenous
-if recurrent or significant may need further investigations for underlying cause like thrombocytopenia or clotting disorders

how to manage nosebleed by the patient
-sit up and told head forward
-squeeze soft part of nostril together for 10-15 minutes
-spit out any blood in the mouth rather than swallowing

Question 6

when may a patinet iwht epistaxis need hospital admission 4

Answer 6

if not stop after 10-15 mins

nosebleed severe

bleeding from both nostrils

hemodynamically unstable

Question 7

treatment options for severe nosebleeds 2

Answer 7

nasal packing
-usuing nasal tampons
-or
-inflatable packs

nasal cautery
-using silver nitrate sticks

Question 8

after treatment for an acute epistaxis what can be considered 1

Answer 8

prescribing naseptin nasal cream (chlorhezidine and neomycin)
-given for QD for 10 days to reduce crusting, inflammation and infection

(this is CI in peanut or soya allergy)