Epistaxis (Nosebleeds )

Epistaxis ( nosebleeds ) is bleeding from the nasal cavity.

How common- Most common ENT emergency presentation in primary care Up to 60 % of the population will suffer from epistaxis atleast once in their lifetimeBut -only 6 % will require medical attention Bimodal age distribution ( ↑ ed prevalence in children and aged )Most cases in age group 2-10 and 50-70 yrsRare below age 2 and may indicate serious illness like leukaemia or injury More common in winter No racial or gender predilection Allergic rhinitis and use of nasal medications can be risk factors

Classified as Anterior or Posterior- division lies at the piriform aperture

Anterior - Most are anterior ~ 90 % Usually from Kiesselbach plexus- rich vascular anastomosis located at anterior nasal septum called Littles area ( see below ) Kiesselbachs plexus gets blood supply from both internal and external carotid artery Usually from one nostril

Posterior-Approximately 10 % Origin is from the posterior nasal cavity or nasopharynx More commonly arterial in origin Pose greater risk of airway compromise , aspiration and difficulty in management More common in older people Blood running into the throat or from both nostrils

Topical treatment -Naseptin is chlorhexidine + neomycin Reduces...