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Epistaxis

Epistaxis

Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...

Tonsillitis II: Management

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Cardiopulmonary Resuscitation II: ACLS Airway Management

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Esophageal Varices-II: Clinical Features and Management

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Venous Thrombosis IV: Nursing Management

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Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...

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Updated: Jul 6, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

A change in UK epistaxis management.

Tahwinder Upile¹, Waseem Jerjes, Fabian Sipaul

¹Department of Maxillofacial Surgery, Head and Neck Unit, University College London Hospitals, London, UK. mrtupile@yahoo.com

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

|April 9, 2008

Summary

A revised protocol for managing nosebleeds (epistaxis) in the UK significantly reduced hospital admissions by 73%. This new approach allows safe home management for many patients, saving valuable hospital resources.

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Last Updated: Jul 6, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

Area of Science:

Otolaryngology
Oral and Maxillofacial Surgery
Emergency Medicine

Background:

Ear, nose, and throat (ENT) and oral and maxillofacial surgery services in the UK are shifting towards primary care.
Epistaxis (nosebleeds) is a common ENT/oral and maxillofacial surgery emergency with potentially severe outcomes.
Current management often involves hospital admission for nasal packing.

Purpose of the Study:

To implement and evaluate a revised clinical protocol for epistaxis management in an Accident and Emergency (A&E) department.
To compare the outcomes of the revised protocol with routine management for epistaxis of local origin.

Main Methods:

A revised protocol using Netcel polyvinyl alcohol sponge nasal tampons was applied to 60 consecutive epistaxis patients.
A proforma was created for data collection in the A&E department.
Retrospective data from the previous 4 years for epistaxis patients were analyzed for comparison.

Main Results:

The revised protocol significantly reduced total admissions by 73% (P < 0.0001).
There was no significant change in monthly epistaxis referrals.
The mean age of admitted patients increased, and the protocol saved 201 bed days annually.

Conclusions:

Routine epistaxis cases can be safely managed at home with proper nasal packing and patient advice.
This revised protocol represents a significant change from current UK management standards.
The study supports the adoption of this policy by primary and secondary care within the NHS, presenting an economic argument.