Epistaxis is defined as bleeding from the nose.
- Commonest cause for epistaxis is idiopathic ( 90% ).
- Traumatic following nose or skull base fracture or iatrogenic.
- Inflammatory as in rhinitis ,sinusitis and nasal granulomas.
- Neoplastic as hemangioma and angiofibroma.
- Deviated septum and septum perforation.
- 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:-
- 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.
- Assessment:- history taking and examination for site , severity ,shock and cause of bleeding.
- 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.
- Treatment of the underlying cause:- known through history taking and lab investigations.