Epistaxis

See also earlier Emergencies section. (p. 300). Epistaxis can be caused by trauma, dry weather, hypertension, bleeding dyscrasias, anticoagulation therapy, and intranasal tumors. Adolescent boys with recurrent epistaxis and nasal obstruction might have juvenile nasopharyngeal angiofibroma. Epistaxis typically responds to conservative treatment, including nasal hydration with saline mist, nasal ointment, environmental humidification, avoidance of digital trauma, and control of hypertension if present. If bleeding continues to be a problem, the patient should be referred to an ENT consultant for a complete evaluation of the nasal cavities and possible cautery. Screening blood studies for coagulopathy may be necessary.

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