Epistaxis resident survival guide: Difference between revisions

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==Treatment==
==Treatment==
Shown below is an algorithm summarizing the treatment of <nowiki>[[disease name]]</nowiki> according the the [...] guidelines.
Shown below is an algorithm summarizing the treatment of <nowiki>[[disease name]]</nowiki> according to the [...] guidelines.


Statement Action Strength
Statement Action Strength
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{{familytree | | | | | D01 | | | | | | | | | | | D02 | |D01=Yes→Nasal compression for≥5 min| D02=No}}
{{familytree | | | | | D01 | | | | | | | | | | | D02 | |D01=Yes→Nasal compression for≥5 min| D02=No}}
{{familytree | | |,|-|-|^|-|.| | | | | | | | | | |!| | | | }}
{{familytree | | |,|-|-|^|-|.| | | | | | | | | | |!| | | | }}
{{familytree | | E01 | | E02 |-|-|-|-|-|-|-|-|-|-| E03 | | | | |E01=Bleeding resume|E02=Bleeding stopped|E03=Rhinoscopy to identify location of bleeding}}
{{familytree | | E01 | | E02 |-|-|-|-|-|-|-|-|-| E03 | | | | |E01=Bleeding resume|E02=Bleeding stopped|E03=Rhinoscopy to identify location of bleeding}}
{{familytree | | |!| | | | | | | | | | | | | | | |!| |!| | | | }}
{{familytree | | |!| | | | | | | | | | | | | | | |!| | | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | F02 | | |!| |F01=Risk assesment (Assess for Hereditary Hemoragic Telangiectasia|F02=F02}}
{{familytree | | | F01 | | | | | | | | | | | | | |F02 | | |F01=Risk assesment (Assess for Hereditary Hemoragic Telangiectasia|F02=Bleeding site identified?}}
{{familytree | | | |!| | | | | | | | | | |,|-|^|-|.| |!| | }}
{{familytree | | | |!| | | | | | | | | | | |,|-|-|^|-|-|.| | | }}
{{familytree | | | | G01 | | | |G02 | | | | | G03 | | G04 |!| | |G01=Rhinoscopy to identify location of bleeding|G02=G02|G03=G03|G04=G04}}
{{familytree | | | | G01 | | | | | | | | G03 | | | | | | G04 | | | |G01=Rhinoscopy to identify location of bleeding| G03=<div style="float: left; text-align: left; height: 7em; width: 14em; padding:1em;"> '''Yes→ Three options:'''<br>
{{familytree | | |,|-|^|-|.| | | | | | |!| | | |!| |!| | }}
----
{{familytree | | | H01 | | H02 | | | | | |!| | | H03 |'| | | |H01=Bleeding site Identified|H02=Bleeding site not identified|H03=H03}}
❑ 1=Lubricants <br> ❑ 2=Topical vasoconstrictors <br> ❑ 3=Nasal cautery </div>| G04=No}}
{{familytree | | | |!| | | |!| | | | | | |!| | | |!| | | | | }}
{{familytree | | |,|-|^|-|.| | | | | | | |!| | | | | | | }}
{{familytree | | | I01 | | |!| | | | | | |!| | | I02 | | | |I01=Anestesia bleeding site and limit nasal cautery to site|I02=I02}}
{{familytree | | | H01 | | H02 | | | | | H03 | | | | | | |H01=Bleeding site Identified|H02=Bleeding site not identified| H03=Decision for nausal Cautery? | H04= }}
{{familytree | |,|-|^|-|.| |!| | | | | | |!| |,|-|^|-|.| | | |}}
{{familytree | | | |!| | | |!| | | | |,|-|^|.| | | | | | | | | | }}
{{familytree | J01 | | J02 |!| | | | | | |!| J03 | | J04 | | | |J01=Bleeding stopped|J02=Bleeding resume|J03=J03|J04=J04}}
{{familytree | | | I01 | | |!| | | | I02 | | I03 | | I04 | | | |I01=Anestesia bleeding site and limit nasal cautery to site|I02=Yes→ Anestesia bleeding site and limit nasal cuatery to site | I03=No | I04= }}
{{familytree | |!| | | |!| |!| | | | | | |!| |!| | | |!| | |}}
{{familytree | |,|-|^|-|.| |!| | | | | | | | | | | | | | | | |}}
{{familytree | J01 | | J02 |!| | | | | | | | | | | | | | | |J01=Bleeding stopped|J02=Bleeding resume|J03=J03|J04=J04}}
{{familytree | |!| | | |!| |!| | | | | | | | |!| | | |!| | |}}
{{familytree | K01 | | | K02 | | | | | | | | | |!| | | K02 | |K01=K01|K02=Suspected Bleeding site HHT* or Anticoagulants?}}
{{familytree | K01 | | | K02 | | | | | | | | | |!| | | K02 | |K01=K01|K02=Suspected Bleeding site HHT* or Anticoagulants?}}
{{Familytree | | | | |,|-|-|^|-|-|.| | | | | |!| | }}
{{Familytree | | | | |,|-|-|^|-|-|.| | | | | |!| | }}
Line 96: Line 98:
{{Familytree | | | | | G01 | | G02 | | |!| | |!| |G01=G01| G02=G02}}
{{Familytree | | | | | G01 | | G02 | | |!| | |!| |G01=G01| G02=G02}}
{{Familytree | | | | | |!| | | |!| | | |!| | |!| | }}
{{Familytree | | | | | |!| | | |!| | | |!| | |!| | }}
{{Familytree | | | | | H01 | | |!| | | |!| | |!| |H01=H01}}
{{Familytree | | | |,|-|^|-|.| |!| | | |!| | |!| | }}
{{Familytree | | | I01 | | I02 |!| | | |!| | |!| |I01=I01| I02=I02}}
{{Familytree | | | |!| | | |!| |!| | | |!| | |!| | }}
{{Familytree | | | J01 | | |!| |!| | | |!| | |!| |J01=J01}}
{{Familytree | |,|-|^|-|.| |!| |!| | | |!| | |!| | }}
{{Familytree | K01 | | K02 |!| |!| | | |!| | |!| |K01=K01| K02=K02}}
{{Family tree | |!| | | |!| |!| |!| | | |!| | |!| | }}
{{Family tree | |!| | | |!| |!| |!| | | |!| | |!| | }}
{{familytree/end}}
{{familytree/end}}

Revision as of 09:43, 14 August 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords:

Overview

Epistaxis also known as noes bleeding, is a terminology name for bleeding of nose vessels that drains out from nostril (most often) and/or nasopharynx. Epistaxis is often stop easily but sometimes it's an ENT emergency which can be critical if appropriate action does not occur. Kiesselbach's plexus is the source of most epistaxis.

Causes

Base on the cause and severity of Epistaxis it can be life threatening.

Life Threatening Causes

Life-threatening causes of epistaxis include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Diagnosis

Shown below is an algorithm summarizing the diagnosis of Epistaxis according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according to the [...] guidelines.

Statement Action Strength


 
 
 
 
 
 
 
 
 
Patient with epistaxis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does the patient need immediate action?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes→Volume replacement,airway check, Needs for emergency departement
 
 
 
 
 
 
 
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Active Bleeding?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes→Nasal compression for≥5 min
 
 
 
 
 
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bleeding resume
 
Bleeding stopped
 
 
 
 
 
 
 
 
 
Rhinoscopy to identify location of bleeding
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Risk assesment (Assess for Hereditary Hemoragic Telangiectasia
 
 
 
 
 
 
 
 
 
 
 
 
 
Bleeding site identified?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Rhinoscopy to identify location of bleeding
 
 
 
 
 
 
 
Yes→ Three options:

❑ 1=Lubricants
❑ 2=Topical vasoconstrictors
❑ 3=Nasal cautery
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bleeding site Identified
 
Bleeding site not identified
 
 
 
 
Decision for nausal Cautery?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Anestesia bleeding site and limit nasal cautery to site
 
 
 
 
 
 
 
Yes→ Anestesia bleeding site and limit nasal cuatery to site
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bleeding stopped
 
Bleeding resume
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
K01
 
 
Suspected Bleeding site HHT* or Anticoagulants?
 
 
 
 
 
 
 
 
 
 
 
 
 
Suspected Bleeding site HHT* or Anticoagulants?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NO→Non absorbable or absorbable packing(Preferred in children)
 
 
 
Yes→Absorbable packing
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Nasal packing education
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bleeding controlled
 
Bleeding resume
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
H01
 
Patient doesn't use anticoagulant or antiplatelet medications
 
Patient use anti coagulant or antiplatelet medications
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
I01
 
 
 
 
 
Life treatening nose bleeding?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes→ Evaluate need for or risk of discontinuation Anti-Coag/Anti-Platelet medications
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
K01
 
 
 
Bleeding controled
 
Bleeding resume
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
L01
 
L02
 
 
 
 
 
 
Evaluate candidency for Embolization or Surgical arterial ligation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
E01
 
 
 
Appropriate intervention which may include Embolization, Surgety, Additional packing or cautery
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
F01
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
G01
 
G02
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References


Template:WikiDoc Sources