Overview of Etiology and Management of Epistaxis: Through the Mnemonic EPISTAXIS.

Abstract

Objectives: This study investigated the rate of application of various treatment steps for epistaxis using the mnemonic EPISTAXIS.

Methods: Two thousand three hundred patients with epistaxis (1284 males and 1016 females) meeting the inclusion criteria from various centers in different regions of Turkey were enrolled in the study. All presented to the Emergency Department with epistaxis. Each patient was evaluated on the following items: cause of the epistaxis, accompanying diseases, and interventions performed (using the EPISTAXIS Mnemonic).

Results: Idiopathic epistaxis was found in 80.0% of cases. Other causes included home accidents (7.7%), finger trauma (3.9%), rhinosinusitis (2.8%), and foreign bodies (2.4%). Hypertension was the most commonly detected accompanying condition (39.0%). Other diseases included diabetes mellitus (17.9%), blood disorders related to epistaxis (6.1%), and malignancy (5.9%). Intervention performed (EPISTAXIS Mnemonic) results were as follows:Examination: Anterior epistaxis was detected at 95.0% and posterior epistaxis at 5.0%. Pressure (apply pressure over the nose with fingers) was applied in 48.3%. Irrigation (irrigate with warm water) was performed at 0.52%. Silver nitrate: Cauterization was applied at a concentration of 22.86%. Tampons/nasal pack (anterior or posterior tampon) were applied at 73.86%. Afrin: Vasoconstrictor spray (oxymetazoline spray) was applied to a tampon at 40.34%. Transamine-tranexamic acid-applied on a tampon was performed at 17.0%. Interventional radiology (embolization) was not performed (0.0%). Surgical consultation: ENT consultation was requested at 11.3%.

Conclusions: For the treatment of epistaxis, the mnemonic EPISTAXIS (1) is suggested for a proper understanding and recall of appropriate treatment steps.