Epistaxis SSOU Guideline
Definition
Unilateral epistaxis due to vascular fragility/ local trauma, that has required packing - now controlled
Admission Criteria
- Awaiting recovery from procedure or short term management of epistaxis
- Observation after removal of nasal packs
- Epistaxis ceased or controlled
Exclusion Criteria
- Uncontrolled bleeding
- Signifi cant underlying cardiac or respiratory disease
- Hypotension requiring on-going resuscitation
- Recent ENT surgery or abnormal anatomical variants
Investigations
Required
- FBE
As indicated
- Coag/INR
- UEC
- Group and hold
Suggested Medications
Drug Dose Frequency Route Cephalexin for duration of nasal packing 500mg QID oral Paracetamol 1g 4/24 oral Specific Observations
Nil
Specific Management Issues
- Nurse with head up 45-90 degrees
- Avoid hot drinks, hot showers
- If ENT follow up likely to be required it is essential that the ENT resident see the patient in SSOU (or they will not get a clinic slot)
- Ensure pack removal arranged
Discharge Criteria
- Bleeding controlled
- Definitive treatment has occured (either packing or cautery, self-resolved bleeds are just waiting to start up again)
- Adequate social supports
Hospital Admission Criteria
- Complications of procedure
- Persistent or recurrent bleeding
- Abnormal vital signs
- Inadeqate social supports.