Management of Epistaxis

Abstract

Epistaxis is a common phenomenon in the emergency departments. Each year, nearly 5-10% of the public experience an active nasal bleeding. Among acute otorhinolaryngologic emergency disorders, epistaxis is the most common one and affects persons of all ages and both sexes. Its incidence is higher in males when compared to females. Most episodes are uncomplicated while 6% require medical attention. Epistaxis has a bimodal distribution with the frequency of occurrence peaking twice at the ages of 2-10 and 50-80. About 30% of children up to 5 years old have had at least one epistaxis. Its incidence is very low in babies and decreases after puberty. In autumn and winter, the incidence of epistaxis increases due to upper respiratory tract infections, overheating of closed areas, and lack of moisture. Epistaxis, which can be a severe or even fatal condition, refers to bleeding of nasal mucosa and is associated with significant morbidity and occasional mortality. Based on the primary bleeding site, epistaxis is defined as anterior or posterior. Typically, the origin of bleeding is the Kiesselbach’s plexus which is an anatomic network of vessels on the anterior portion of the nasal septum. Blood vessels within the nasal mucosa are superficial and therefore unprotected. In this chapter, management of epistaxis is discussed in all aspects.