Bedside Tip: If You See This, Consult ENT
SHORT ANSWER MANAGEMENT QUIZ:
1. Name the most common location from where nosebleeds originate
2. List five potential causative factors
3. List three possible indications for hospitalization in a patient with epistaxis
Did you know that 90% of nosebleeds resolve with pinching just below the nasal bone and packing? If you have good control of bleeding after packing the anterior nasal cavity, but still see bleeding down the back of the throat, time to consult your ENT colleagues to rule out a posterior bleed.
1. Kiesselbach’s plexus/Little’s Area
2. a) Nose picking
b) Acute infection (i.e. rhinosinusitis)
c) Facial trauma
d) Blood dyscrasias
e) Anticoagulant medications
3. a) Hemodynamic instability
b) Inability to control bleeding/identify source of bleed
c) Inability to follow up for removal and reassessment of packing within 24-48 hours
As well, check out Dr. Dupuis' other blog post on Epistaxis to learn a mnemonic that's helpful when considering what else it might be!