Nose & Sinuses: Epistaxis

Question 1

Patient presents with anterior epistaxis, where are they bleeding from? What is your treatment?

Answer 1

Bleeding from the Kiesselbach plexus. Direct pressure while patient is sitting up and leaning forward. If it continues for longer than 15 mins - ID the site of bleeding. Topical cocaine can be used as an anesthetic. Then cauterize

Question 2

What are some risk factors?

Answer 2

nasal trauma (including nose picking), dry nose, hypertension, nasal cocaine use, and alcohol use.

Question 3

If your patient has a posterior epistaxis, where would it be from?

Answer 3

From Woodruff plexus - also associated with hypertension & atherosclerosis.