Epistaxis

Epistaxis is extremely common and usually managed with simple first aid measures in the community. However it can also present with life-threatening haemorrhage which requires appropriate resuscitation and arrest of the bleeding. Of those patients presenting to local emergency services, knowledge of the assessment and management of epistaxis are essential. Epistaxis is classified as primary epistaxis, where no cause can be found or secondary epistaxis where there is a defined cause. It is also described in terms of the site of bleeding. Anterior bleeding from the nasal septum is found in 90% of cases and can be controlled with simple first aid measures or nasal packing and/or cautery. Posterior bleeding is more dramatic and may require a surgical procedure or radiological guided embolization. Many patients, particularly the elderly, have associated co-morbidities and medications that need to be addressed along with the standard treatment. This article discusses the assessment and appropriate management of patients with epistaxis and their associated morbidities.