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Who should treat epistaxis?

  • D. G. John (a1), A. I. Alison (a2), D. J. A. Scott (a2), A. R. McRae (a3) and M. J. Allen (a4)...

Abstract

A prospective study was undertaken of 75 patients complaining of epistaxis who presented to an Accident and Emergency Department.

The patients were placed into four groups according to their presenting features, and various forms of appropriate management applied.

It was found that in the group that had ceased bleeding on presentation, whether or not a bleeding point was visible, there was no benefit obtained by treatment. If the nose was still bleeding on presentation, and the bleeding point was visible, successful management could be obtained by cauterising the bleeding point. This is a treatment that could be carried out by either the General Practitioner or the Accident Department. If the nose was actively bleeding, and the bleeding point could not be seen, then even initially successful treatment by the Accident Department was usually found to be ineffective within forty-eight hours. It is suggested that this group should be referred to an ENT unit on presentation.

Copyright

Corresponding author

M. J. Allen, F.R.C.S., Senior Registrar in Accident & Emergency, The Leicester Royal Infirmary, Leicester LE1 5WW.

References

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Hicks, J. N. and Norris, J. W. (1983) Office treatment by Cryotherapy for severe posterior nasal epistaxis. Laryngoscope, 93: 876879.
Joseph, M. P., Kelly, J. H., Fried, M. P. and Strome, M. (1981) Alternatives of anterior-posterior packs for epistaxis. Plastic and Reconstructive Surgery, 67: 530533.
Key, G. (1981) Stopping nose bleeds in the elderly. Pressure, packing or cautery. Geriatrics, 36: 7480.
Ludman, H. (1981) ABC of Ear, Nose and Throat. Torquay Devonshire Press.
Nassif, A. C. N. (1983) A new procedure in nasal packing to stop bleeding. Laryngoscope, 93: 12221224.
Petruson, B. and Rudin, R. (1975) The frequency of epistaxis in a male population sample. Rhinology, 13: 129133.
Small, M., Murray, J. A. M. and Maran, A. G. D. (1982) A study of patients with epistaxis requiring admission to hospital. Health Bulletin, 40: 2029.
Tucker, W. N. (1963) The investigation and treatment of epistaxis. A report of one hundred and sixty four cases. New Zealand Medical Journal, 62: 283287.
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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