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Paediatric epistaxis: Alder Hey experience
Zvoru G G Makura1, Graham C Porter, Max S McCormick
1Department of Otolaryngology, Royal Liverpool Children's Hospital-Alder Hey, Liverpool, UK. Zmakura@aol.com
Insights
Paediatric epistaxis (nosebleeds) can be effectively managed in a single outpatient visit. Treatments like topical creams and silver nitrate cautery show high parent satisfaction and reduce repeat GP consultations.
Area of Science:
- Otolaryngology
- Pediatric Medicine
Background:
- Epistaxis is a common reason for pediatric Ear, Nose, and Throat (ENT) referrals.
- Effective management strategies are crucial for improving patient outcomes and reducing healthcare burden.
Purpose of the Study:
- To evaluate the effectiveness of a single-outpatient-consultation approach for managing pediatric epistaxis.
- To assess patient and parent satisfaction with topical treatments and chemical cautery.
Main Methods:
- Prospective audit of 88 new pediatric epistaxis referrals over four months.
- Data collection via parent questionnaires on history and frequency.
- Assessment and treatment including topical chlorhexidine and neomycin cream (Naseptin) and silver nitrate cautery.
- Follow-up postal questionnaires and general practitioner telephone surveys.
Main Results:
- Outpatient nasal cautery was tolerated by 98% of children.
- 74% of parents found Naseptin useful.
- 91% of children did not require further GP consultations for epistaxis post-treatment.
Conclusions:
- Pediatric epistaxis can be effectively managed through a streamlined, single outpatient consultation.
- The combined approach of topical treatment and chemical cautery offers a high success rate and patient satisfaction.
Abstract:
Referrals for epistaxis management constitute a significant proportion of paediatric ENT consultations. A prospective audit of all new referrals to our paediatric ENT department for epistaxis management yielded 88 patients over four months. Parents completed a questionnaire with particular reference to the duration of history and frequency of epistaxis. After assessment some patients were given topical chlorhexidine and neomycin cream (Naseptin), in addition some children also underwent chemical cautery (silver nitrate). Of the 64 children in whom out-patient nasal cautery was attempted it was tolerated by 63 (98 per cent). In response to a follow-up postal questionnaire returned by 65 per cent, most parents (74 per cent) felt that Naseptin was useful. A telephone survey of the patients' general practitioners found that 91 per cent of the children did not consult their general practitioner regarding epistaxis again. We conclude that paediatric epistaxis can be effectively managed with a single out-patient consultation.
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