Evaluation and management of acute epistaxis in the emergency department

Acute epistaxis, or nosebleed, is a common presentation in the emergency department (ED) that requires a systematic evaluation and prompt management. The assessment involves considering the severity of bleeding, identifying underlying causes, and implementing appropriate interventions. Modifiable risk factors, such as medication review, nasal hygiene, avoidance of nasal trauma, and humidification, should be addressed to prevent recurrence. Referral to specialists is necessary for cases of recurrent or severe bleeding, suspected underlying causes, or inadequate response to initial management. Collaboration between ED healthcare providers and specialists ensures comprehensive evaluation, specialized interventions, and long-term management. Regular follow-up appointments and patient education are essential for monitoring progress, adjusting treatment, and preventing complications. By employing a comprehensive approach, healthcare providers aim to alleviate distress, achieve hemostasis, identify underlying etiologies, and optimize patient outcomes in the ED.

¿Lo sabes todo sobre epistaxis? / Do you know all about epistaxis?

La epistaxis es un síntoma muy común es muestra práctica diaria, aproximadamente el 60% de la población ha tenido al menos un episodio en algún momento de su vida pero solo 6% precisó atención médica. La mayoría de episodios son limitados y benignos pero, en ocasiones, nos encontramos con casos que pueden resultar fatales.

Nosebleed is a really common symptom, about 60% of the population has had at least one episode at some point in their lives but only 6% required medical attention. Most episodes are limited and benign but in some rare cases, it could be deathly.

Transcatheter arerial embolization of acute obstinate nosebleed / 介入放射学杂志

Objective To investigate the value of transcatheter arterial embolization in the treatment of obstinate nosebleeding. Methods Twenty patients with obstinate nosebleed failed with conventional therapy were performed internal maxillary arterial angiography. Transcatheter arterial embolization were carried out immediately after occurance of nosebleeding. PVA or gelfoam particles were injected into the bleeding arteries under fluoroscopy control. Nasal packing was removed to see whether bleeding was stopped. Results Active bleeding occurred in all 20 patients during angiography but was stopped in all patients after embolization without severe complications. Conclusions Transcatheter arterial embolization is an useful mini-invasive method in the treatment of obstinate nosebleeding.