• Epistaxis SSOU Guideline


    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




    • 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


    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.
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