Management of epistaxis in general practice.

BACKGROUND

The vast majority of cases of epistaxis can be managed successfully within general practice.

OBJECTIVE

To describe a range of clinical interventions in the management of epistaxis appropriate to general practice.

DISCUSSION: A number of relatively simple treatments and procedures may provide relief for anterior nasal bleeding, which is the site for over 80% of cases of epistaxis. Where more procedural interventions are necessary, adequate preparation and appropriate tools are required to perform these processes safely. Initial identification of the site of bleeding before commencement of treatment may be difficult but allows the correct treatment to be applied with minimal discomfort to the patient. More copious bleeding which constitutes less than 5-10% of cases, is usually the result of posterior nasal bleeding and is best treated in a facility well set up to handle such an eventuality. In cases of chronic epistaxis, a number of interventions, medical and surgical have been trialled with variable success, and should be used with caution in general practice.