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Severe Epistaxis in the Pediatric Patient: A Simulation for Emergency Department Management

Olivia Gorbatkin1, Jean Pearce2, Monique Goldschmidt3

  • 1Pediatrics, University of Washington, Seattle, USA.

Cureus
|September 15, 2022
PubMed

Insights

Severe pediatric epistaxis (nosebleeds) requires emergent management to prevent airway compromise and hemorrhagic shock. This case study emphasizes critical interventions and resuscitation for children with liver disease experiencing severe nosebleeds.

Area of Science:

  • Pediatric Emergency Medicine
  • Hepatology
  • Critical Care

Background:

  • Severe epistaxis in children poses risks of airway compromise and hemorrhagic shock.
  • Underlying liver disease complicates management due to coagulopathy and altered resuscitation needs.

Purpose of the Study:

  • To educate pediatric emergency medicine trainees on managing severe epistaxis in a simulated pediatric patient.
  • To highlight critical resuscitation strategies for pediatric patients with liver disease and severe bleeding.

Main Methods:

  • A simulated case of an 11-month-old with liver disease and severe epistaxis was presented.
  • The simulation focused on immediate bedside interventions and clinical management steps.

Main Results:

  • The simulation aimed to enhance provider preparedness for managing severe, difficult-to-control epistaxis.
  • It underscored the importance of tailored resuscitation in pediatric liver disease patients.

Conclusions:

  • Prompt and effective management of severe pediatric epistaxis is crucial for patient outcomes.
  • Special considerations for resuscitation, including massive transfusion protocols, are vital for pediatric patients with liver disease and bleeding.

Keywords:
epistaxishemorrhagic shockliver diseasenasal packingpediatric emergencysimulationvolume resuscitation

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