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Epistaxis is one of the commonest presentations at the accident and emergency (A&E) department and is the most common ENT emergency (1). Most cases of nose bleeds are minor or self limiting but rarely can be a life threatening emergency due to massive bleeding (1,2).

An estimated 60 % of the general population has had at least one episode of epistaxis throughout their life time (2).

  • out of these only 6% sought medical assistance for it
  • 1.6 in 10,000 required hospitalisation (3)
  • a bimodal distribution is seen in the poulation
    • the incidence peaks at ages less than 10 years and above 50
    • in the young, the blood comes from Little's area, a highly vascular area at the anterior border of the nasal septum. With age the site of bleeding moves posteriorly (2)
  • rare in children under the age of 2 years and if present is often associated with injury or serious illness (4)
  • seasonal variation can also be seen with an increase during the winter months (4)
  • occurs frequently in males than in females (2)

Epistaxis may be due to local causes or general causes.

Epistaxis is usually classified into two types:

  • anterior bleeding  
  • posterior bleeding (2)



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