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)
- (1) Tikka T. The Aetiology and Management of Epistaxis. Otolaryngology Online Journal (2016) Volume 6, Issue 2
- (2) Kucik CJ. Management of epistaxis. American Family Physician 2005; 71(2)
- (3) Upile T, et al. A change in UK epistaxis management. Eur Arch Otorhinolaryngol. 2008;265(11):1349-54
- (4) McIntosh N, Mok JY, Margerison A. Epidemiology of oronasal hemorrhage in the first 2 years of life: implications for child protection. Pediatrics. 2007;120(5):1074-8