Clinical approach to pediatric epistaxis.

Epistaxis is a common concern in the pediatric population. Although the underlying cause is often benign, epistaxis may also be a symptom of more concerning pathology. Despite the frequency with which epistaxis arises in these patients, a standardized approach to assessment and management has not been established, leading to potential gaps in care. This article outlines a systematic approach to evaluating and managing pediatric epistaxis with the aim of improving prompt recognition and ensuring timely intervention. To inform this approach, the article provides an overview of the broad differential diagnosis of epistaxis, ranging from the benign and often self-limiting to critical red-flag signs and symptoms of possible serious underlying pathology. Namely, recurrent or severe epistaxis may indicate systemic conditions, bleeding dyscrasia, tumors, or structural anomalies that require specialty consultation. Clinicians should be aware of the indications for advanced diagnostic evaluation as well as criteria for timely specialty referral in cases of recurrent, severe, or suspicious epistaxis. By implementing this systematic approach, clinicians can reduce delays in appropriate referrals, ultimately enhancing comprehensive pediatric epistaxis care.