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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Thursday, October 6, 2016

Posterior Epistaxis Management

emDocs - October 6, 2016 - Author: Simon E - Edited by: Koyfman A and Singh M
"Epistaxis is one of the most commonly encountered ear, nose, and throat (ENT) emergencies in the US.1-4 It is estimated that up to 60% of the population will experience an episode of epistaxis throughout their lifetime; with approximately 10% having a bleeding source localized to the posterior nares. Current data demonstrate a bimodal age distribution of epistaxis with the majority of cases occurring amongst those aged 2-10 years and 50-80 years. Despite this reported prevalence of epistaxis, epidemiologic data cite only 6% of individuals as presenting to healthcare providers for anterior epistaxis treatment, and only 5% for posterior epistaxis treatment.
Seasonal variation in the rates of epistaxis have been described in temperate and tropical climates. The majority of epistaxis episodes in the US occur during the winter months, a finding thought secondary to a decrease in ambient humidity and increase in concomitant upper respiratory infections. In tropical climates, epistaxis occurs frequently during dry seasons...
The Evaluation of a Patient Presenting with Epistaxis
Evaluation should begin with an assessment of the ABCs. If the patient is actively bleeding, but protecting his airway and hemodynamically stable, he should be placed in a seated position (leaning forward so as to avoid increasing the flow of blood to the posterior oropharynx), and instructed on the application of direct pressure to the bilateral nares for approximately 5-10 minutes. Expectoration of blood residing in the oropharynx should be encouraged so as to reduce the risk of aspiration or emesis..."