EPISTAXIS Causes & Management

What is the medical term for bleeding from the nose?

Epistaxis

Where is the most common site for nosebleeds?

Little’s area, located in the antero-inferior part of the nasal septum.

What arteries contribute to the blood supply of the Little’s area?

Anterior ethmoidal artery, Sphenopalatine artery, Greater palatine artery, Superior Labial artery.

What is Kiesselbach’s plexus?

A highly vascular anastomosis in the nasal cavity where multiple blood vessels converge, making it a common site for epistaxis.

What is Woodruff’s area?

A venous plexus located at the posterior end of the inferior turbinate that can also be a site of nosebleed.

What are the two classifications of causes for epistaxis?

Local causes and Systemic causes.

Name a congenital cause of epistaxis.

Osler Weber Rendu syndrome (Telangiectasia).

What is the commonest acquired cause of epistaxis?

Nose picking.

List some infections that can cause epistaxis.

Acute Rhinitis, Vestibulitis, Sinusitis, Adenoiditis, Diphtheria, Atrophic rhinitis.

What type of tumors can lead to epistaxis?

Nasal Polyps, Juvenile Angiofibroma, Haemangioma, Inverted papilloma, Malignant tumors of the nose.

What systemic condition is often associated with epistaxis?

Hypertension.

What is the final cause of epistaxis mentioned?

Idiopathic causes.

What are some key steps in the management of recurrent nasal bleeding?

Adequate clinical history, comprehensive physical examination, investigations, definitive treatment.

What should be included in a comprehensive history for a patient with epistaxis?

Onset, duration, frequency of bleeding, seasonal variation, associated nasal symptoms.

What kind of tests are included in the investigations for epistaxis?

Full blood count, clotting profile, renal function tests, liver function tests, X-ray of paranasal sinuses.

Name two methods to stop epistaxis mentioned in the notes.

Cold compress and nasal packing.

What is a common chemical cauterisation agent for epistaxis?

Silver nitrate.

What is the ABCD rule in resuscitation?

A - Airway, B - Breathing, C - Circulation, D - Definitive treatment.

What definitive surgical treatment may be necessary for severe epistaxis?

Arterial ligation, such as ligation of the External Carotid Artery or the Maxillary Artery.

What should a conscious patient do to help stop a nosebleed?

Sit with the head bent forward and pinch the nose.