EVALUATION OF AETIOLOGY AND EFFICACY OF MANAGEMENT PROTOCOL OF EPISTAXIS
AbstractBackground: Epistaxis is one of the commonest medical emergencies. It affects all age groupsand both sexes. The cause may be local or systemic but in majority it is spontaneous andidiopathic. Trauma is considered to be a major aetiological factor. Various treatment protocols areutilized to control epistaxis derpending upon the type, severity and cause of bleeding. Methods:This descriptive study was designed to evaluate the aetiology and efficacy of managementprotocol of epistaxis in a tertiary care setting. 313 patients underwent prospective evaluation byconsultant and non-consultant doctors with considerable experience in Ear, Nose & Throat (ENT)emergencies management. Standard principles were followed in the management. Results: Thisstudy demonstrated a bimodal distribution with incidence peaks in below 25 years & above 50years of age. Males were affected twice more than the females (2.15:1.04). Anterior nasal bleedingwas noted in majority of the patients. Anterior nasal packing was the most effective method ofcontrolling anterior epistaxis. While posterior bleeding was controlled by posterior nasal packingwith Foley’s catheter. The most common cause was found to be trauma, followed by hypertension.Conclusion: It may be concluded from this study that epistaxis is the m ost common ENTemergency, affecting all age groups. It has a bimodal age presentation and affects males twicemore than females. Anterior bleeding is more common than posterior bleeding. Epistaxis may becontrolled with chemical/electro-cautery if the bleeding point is visible. In case of failure tolocalize or access a bleeding point or profuse bleeding, anterior nasal packing can effectivelycontrol majority of epistaxis. Foley’s catheter is a good option that can be used for posterior nasalpacking. Gelfoam may be used for controlling epistaxis in cases of bleeding disorders, when thereis mucosal ooze.Key words: Epistaxis, Nasal packing, Foley’s catheter.
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