ABC of ENT. Nose bleeds.

Ludman, Harold

doi:10.1136/bmj.282.6268.967

Cited by 7 publications

(8 citation statements)

References 0 publications

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“…6 It is common and effects all age groups with higher frequency in elderly males. [1][2][3] Traditionally, epistaxis has been classified as mild, moderate and severe on basis of severity and on basis of site of bleeding as anterior and posterior epistaxis. In our study group only patients that were diagnosed as idiopathic anterior epistaxis were considered.…”

Section: Discussionmentioning

confidence: 99%

“…Expected success rate, e = 86 Observed success rate, o = 90 χ 2 = (o -e) 2 /e = (90 -86) 2 /64 = 16/64 = 0.25 From Chi-square distribution, p-value is found out to be 0.60.…”

Section: Chi-square Test With B and C Considering Group A As Expectedmentioning

confidence: 96%

“…The management of epistaxis, by direct and indirect methods, much relies on the site of bleeding. 1,2,8 As the localization of site of posterior epistaxis is difficult in usual settings indirect method which does not require identification of bleeding point (i.e. nasal packing) is the treatment of choice.…”

Section: Aijcrmentioning

confidence: 99%

“…Between 7 and 14% of adults have epistaxis at some time or other, but only 6% seek medical attention. [1][2][3] Majority of cases of epistaxis stop spontaneously and in the great majority of cases is easily controlled. It may, however, be extremely persistent and, although seldom endangering life, may cause much anxiety to both patient and physician.…”

Section: Introductionmentioning

confidence: 99%

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Control of Anterior Epistaxis: A Comparative Analysis of the Decongestive Effect of Xylometazoline and Adrenaline in Idiopathic Epistaxis in Emergency Settings

Mattoo¹,

Yousuf²,

Mir³

et al. 2011

An International Journal Clinical Rhinology

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Objective To compare the impact of decongestive effect of xylometazoline and adrenaline in controlling active idiopathic anterior epistaxis on adult patients prior to use silver nitrate for cauterization. Study design Prospective case study. Methods The study used a prospective review of 150 consecutive adult patients diagnosed as anterior epistaxis (from August 2010 to January 2011). The study group was analyzed in three groups based on method of intervention used for management of anterior epistaxis. The conventional method of pinching nose and use of xylometazoline (0.5%) or adrenaline (1:10,000) soaked cotton packs for control of active arterial spurt followed in each case with silver nitrate cauterization. Results A total of 150 patients reviewed who were medically fit and subjected to study design in three groups. Fifty adult patients in each group with similar presentation. In first group, 32 patients out of 50 (64%) had successful control of bleeding with silver nitrate cauterization only after pinching nose (for 10 minutes). In second group, it was seen that 43 patients out of 50 (86%) in one group had successful control of bleeding following use of 0.5% xylometazoline-soaked cotton packs (for 10 minutes). prior to silver nitrate cauterization. In another group, 45 patients out of 50 (90%) had successful control of bleeding following use of 1:10,000 adrenaline-soaked cotton packs (for 10 minutes) prior to silver nitrate cauterization. Conclusions 1. Almost all patients with idiopathic anterior epistaxis can be managed more effectively and successfully by the use of vasoconstrictive agents followed by silver nitrate cauterization and risks of anterior nasal packing can be avoided. 2. The success rate of silver nitrate cauterization can be increased significantly with use of vasoconstrictive agents (xylometazoline and adrenaline) for control of actively bleeding arterial spurts prior to cauterization. 3. With the use of adrenaline not suitable in high-risk group patients, like coronary artery disease, cerebrovascular diseases, myocarditis, drugs like beta blockers, tricyclic antidepressants; xylometazoline can safely replace adrenaline in these cases.

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Section: Discussionmentioning

confidence: 99%

“…Expected success rate, e = 86 Observed success rate, o = 90 χ 2 = (o -e) 2 /e = (90 -86) 2 /64 = 16/64 = 0.25 From Chi-square distribution, p-value is found out to be 0.60.…”

Section: Chi-square Test With B and C Considering Group A As Expectedmentioning

confidence: 96%

Section: Aijcrmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Control of Anterior Epistaxis: A Comparative Analysis of the Decongestive Effect of Xylometazoline and Adrenaline in Idiopathic Epistaxis in Emergency Settings

Mattoo¹,

Yousuf²,

Mir³

et al. 2011

An International Journal Clinical Rhinology

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“…If the vessel is identified cautery by either hot wire or silver nitrate is attempted. If haemostasis is not achieved a pack of half inch ribbon gauze, moistened with paraffin or bismuth subnitrate and iodoform paste, is inserted for 48 h and the patient is admitted to a hospital bed (Ludman, 1981;Parker and Clegg, 1990).…”

Section: Introductionmentioning

confidence: 99%

Microscope and hot wire cautery management of 100 consecutive patients with acute epistaxis — a superior method to traditional packing

et al. 1994

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The technique of microscope examination and hot wire cautery in a prospective study of 100 consecutive patients with acute epistaxis is described. The method was successful in arresting haemorrhage in 94 per cent of patients bleeding at the time of examination, and in 86 per cent, discharge home within one hour was possible. Due to improved illumination, magnification and control of the cautery instrument, nasal packing was required in only nine per cent of cases. By achieving this and by reducing the overall need for admission to 20 per cent, we recommend this method of treatment both as a successful cost saving measure, as well as advantageous to the patient.

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