Scribd Logo
Upload

Welcome to Scribd!

  • 24 views

    Epistaxis: A Medical Term For A Nosebleed, Which Is A Common Presenting Complaint in The Emergency Room

    Uploaded by

    Nazurah Azmira
    This document discusses epistaxis (nosebleeds), including causes, diagnosis, treatment, and prognosis. It notes that nosebleeds are commonly seen in emergency rooms and have local causes like nasal trauma or foreign bodies, or systemic causes like bleeding disorders or hypertension. Diagnosis involves history and physical exam to locate the bleeding site. Treatment begins with immediate measures to stop bleeding followed by cauterization, nasal packing, or arterial embolization if needed. Prognosis is usually good except for elderly patients or those with serious medical conditions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Epistaxis: A Medical Term For A Nosebleed, Which Is A Common Presenting Complaint in The Emergency Room

    Uploaded by

    Nazurah Azmira
    24 views11 pages
    This document discusses epistaxis (nosebleeds), including causes, diagnosis, treatment, and prognosis. It notes that nosebleeds are commonly seen in emergency rooms and have local causes like nasal trauma or foreign bodies, or systemic causes like bleeding disorders or hypertension. Diagnosis involves history and physical exam to locate the bleeding site. Treatment begins with immediate measures to stop bleeding followed by cauterization, nasal packing, or arterial embolization if needed. Prognosis is usually good except for elderly patients or those with serious medical conditions.

    Original Title

    Epistaxis.pptx

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses epistaxis (nosebleeds), including causes, diagnosis, treatment, and prognosis. It notes that nosebleeds are commonly seen in emergency rooms and have local causes like nasal trauma or foreign bodies, or systemic causes like bleeding disorders or hypertension. Diagnosis involves history and physical exam to locate the bleeding site. Treatment begins with immediate measures to stop bleeding followed by cauterization, nasal packing, or arterial embolization if needed. Prognosis is usually good except for elderly patients or those with serious medical conditions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    24 views11 pages

    Epistaxis: A Medical Term For A Nosebleed, Which Is A Common Presenting Complaint in The Emergency Room

    Uploaded by

    Nazurah Azmira
    This document discusses epistaxis (nosebleeds), including causes, diagnosis, treatment, and prognosis. It notes that nosebleeds are commonly seen in emergency rooms and have local causes like nasal trauma or foreign bodies, or systemic causes like bleeding disorders or hypertension. Diagnosis involves history and physical exam to locate the bleeding site. Treatment begins with immediate measures to stop bleeding followed by cauterization, nasal packing, or arterial embolization if needed. Prognosis is usually good except for elderly patients or those with serious medical conditions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    You are on page 1of 11

    Epistaxis

    A medical term for a nosebleed, which is a common presenting


    complaint in the emergency room
    Etiology
    Local causes Systemic causes
    • Nasal trauma • Bleeding disorders
    -Anticoagulant and/or aspirin therapy
    -Nose picking (common cause)
    -Von Willebrand disease
    -Fractures to the middle third of the face, base of -Severe thrombocytopenia (e.g., ITP,
    the skull, or the nasal septum leukemia, dengue)
    • Foreign body in the nose -Hemophilia
    • Dry nose (rhinitis sicca) • Hypertension

    • Nasal septal defects (e.g., deviated nasal septum ,


    septal perforation)
    • Infections (e.g., granulomatous diseases such as
    rhinosporidiosis)
    • Tumors of the nasopharynx and/or paranasal
    sinuses (e.g., juvenile angiofibroma)
    • Vascular malformations (e.g., nasal hemangioma,
    hereditary hemorrhagic telangiectasia)
    • Medications, drugs (e.g., topical corticosteroids,
    cocaine)
    Classification
    Diagnosis
    1. Anamnesis
    The history should include
    -duration, severity, frequency, laterality of the bleeds
    -causes
    -interventions provided prior to seeking care
    -anticoagulant, aspirin, or NSAID use
    -drug or alcohol use.
    Include family history of coagulopathies and relevant history
    2. Physical examination
    Before completing a physical exam, prepare proper equipment and
    proper personal protective equipment (PPE).
    Equipment may include a
    -nasal speculum
    -bayonet forceps
    -headlamp
    -suction catheter
    -packing
    -silver nitrate swabs
    Have the patient seated in a sniffing position by having patient flex and
    extend head while keeping the base of nose straight ahead. Carefully
    insert the speculum and slowly open the blades to visualize the
    bleeding site.
    Treatment
    1. Immediate measures
    • Fluid resuscitation if the patient is hemodynamically unstable
    • Keep the patient calm.
    • Elevate the upper body and bend the patient's head forward.
    • Apply cold packs and sustained, direct pressure by pinching the nose
    at the nostrils for 5–10 minutes in order to occlude the bleeding
    vessel.
    • Apply topical vasoconstrictors (e.g., oxymetazoline, phenylephrine)
    2. If epistaxis continues after 10–15 minutes
    • First-line: cauterization of the bleeding vessel using silver nitrate or
    electrocautery.
    • Second-line: nasal packing using gauze impregnated with paraffin and
    antibiotics (covering for Staphylococcus aureus).
    • Anterior epistaxis: anterior nasal packing
    • Posterior epistaxis: posterior nasal packing

    3. If epistaxis persists: arterial embolization or endoscopic ligation of


    the bleeding vessel
    • Anterior ethmoidal artery for anterior epistaxis
    • Sphenopalatine artery for posterior epistaxis
    Anterior nasal packaging

    Posterior nasal packaging


    Prognosis
    For most of the general population, epistaxis is merely a nuisance.
    However, the problem can occasionally be life-threatening, especially in
    elderly patients and in those patients with underlying medical
    problems.
    Fortunately, mortality is rare and is usually due to complications from
    hypovolemia, with severe hemorrhage or underlying disease states.

    You might also like