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Definition:-

Epistaxis is defined as bleeding from the nose.

Aetiology:-

1. Commonest cause for epistaxis is idiopathic ( 90% ).
2. Traumatic following nose or skull base fracture or iatrogenic.
3. Inflammatory as in rhinitis ,sinusitis and nasal granulomas.
4. Neoplastic as hemangioma and angiofibroma.
5. Deviated septum and septum perforation.
6. General causes as hypertension, blood diseases, liver failure, fever.

Epistaxis occur mainly at Little’s area , which is the most site exposed to air and crustation.

Management in epistaxis:-

1. First aid:- patient managed in seated position with head slightly flexed and leaning forward, pinch the nose between index and thumb, don’t swallow blood but spit it , insert a piece of cotton soaked with a vasoconstrictor solution into the nostril for 5-10 m.
2. Assessment:-  history taking and examination for site , severity ,shock and cause of bleeding.
3. Control bleeding :- through first aid , cauterization and nasal packing ( control shock in cases of severe bleeding) , give medications as coagulants , antibiotics, transfusion blood and fluids, observation of vital signs, arterial ligation or embolization.
4. Treatment of the underlying cause:- known through  history taking and lab investigations.