Initial assessment in the management of adult epistaxis: systematic review

Khan, Maha, Conroy, Katherine, Ubayasiri, Kishan, Constable, James, Smith, Matthew E., Williams, Richard J., Kuhn, Isla, Smith, Mary and Philpott, Carl ORCID: https://orcid.org/0000-0002-1125-3236 (2017) Initial assessment in the management of adult epistaxis: systematic review. Journal of Laryngology & Otology, 131 (12). pp. 1035-1055. ISSN 0022-2151

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Abstract

Background: The initial assessment of epistaxis patients commonly includes: first aid measures; observations; focused history taking; clinical examination and investigations. This systematic review aimed to identify evidence to inform us of how the initial assessment of these patients should be conducted. Methods: Systematic review of the literature performed using a standardised methodology and search strategy. Results: Seventeen articles were included. Factors identified were: comorbidity, intrinsic patient factors, coagulation screening and ice pack use. Hypertension and anticoagulant use are demonstrated to adversely affect outcomes. Coagulation screening is useful in patients on anticoagulant medication. Four studies could not be accessed. Retrospective methodology and insufficient statistical analysis limit several studies. Conclusions: Sustained ambulatory hypertension, anticoagulant therapy and posterior bleeding may be associated with recurrent epistaxis, and should be recorded. Oral ice pack use may decrease severity and can be considered as first aid. Coagulation studies are appropriate for patients with history of anticoagulant use or bleeding diatheses.

Item Type:	Article
Uncontrolled Keywords:	epistaxis,comorbidity,cardiovascular diseases,hypertension,risk factors,first aid,therapy,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Depositing User:	Pure Connector
Date Deposited:	05 Sep 2017 05:06
Last Modified:	19 Oct 2023 02:03
URI:	https://ueaeprints.uea.ac.uk/id/eprint/64736
DOI:	10.1017/S0022215117002031

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