Epistaxis

This condition is treated in the Ear, Nose and Throat (ENT) clinic.

Pre-referral work-up

History

All referrals should comply to the referral standards and include:

• Trauma (including nose picking), recent nasal surgery
• Anterior or posterior epistaxis on history
• Coagulopathy, anticoagulants
• Nasal obstruction, change in sense of smell, epiphora, diplopia
• Bleeding stigmata over Little's Area/posterior pharyngeal wall/intranasal mass

Tests

• FBE
• Coagulation screen

Interim/GP management

To refer a patient with this condition, please see the ENT clinic page for the full referral process and templates.

• Direct pressure to nostrils compressing Little's Area
• Prescribe topical bactroban qds to Little's Area for anterior epistaxis
• Silver nitrate (AgNO3) cautery following topical anaesthesia, if not resolving and clinician has previous experience

For more information please see the HealthPathways Tasmania website.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? Persistent bleeding despite first aid measures“ refer immediately to ED

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? Recurrent epistaxis with no overt cause but associated additional history and items italicised in Evaluation - Category 1 (contact ENT Registrar)

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent (Category 2)

Recurrent epistaxis on background of nasal trauma

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Unavailable.
See HealthPathways Tasmania for more information

South

Wellington Clinics
Phone: 03 6166 0000
Fax: 03 6234 9454

To contact the on-call ENT Registrar, phone the switchboard on 03 6166 8308.